SciELO - Scientific Electronic Library Online

 
vol.69 número2Resultados de la implementación del protocolo PETHEMA LPA 99 en el tratamiento de niños con leucemia promielocítica aguda en Bogotá, ColombiaValidación de la versión chilena del cuestionario "Workplace Violence in the Health Sector" en la atención prehospitalaria índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados

Revista

Articulo

Indicadores

Links relacionados

  • En proceso de indezaciónCitado por Google
  • No hay articulos similaresSimilares en SciELO
  • En proceso de indezaciónSimilares en Google

Compartir


Revista de la Facultad de Medicina

versión impresa ISSN 0120-0011

Resumen

DAZA-CAJAS, Gabriel Fernando  y  VALDES-TORRES, Fabián. Diagnostic performance of multislice computed tomography to detect diaphragmatic injuries in hemodynamically stable patients. Preliminary results. rev.fac.med. [online]. 2021, vol.69, n.2, e203.  Epub 30-Jun-2021. ISSN 0120-0011.  https://doi.org/10.15446/revfacmed.v69n2.78672.

Introduction:

Diaphragmatic injuries are a common finding in patients with penetrating thoracoabdominal trauma. Their diagnosis requires exploration through open or laparoscopic surgery. However, multislice computed tomography (MSCT) emerges as a useful noninvasive tool for this purpose.

Objective:

To determine the diagnostic performance of MSCT for detecting diaphragmatic injuries in hemodynamically stable patients with penetrating thoracoabdominal trauma.

Materials and methods:

Prospective study conducted on 119 patients treated at the Hospital Universitario del Valle, Cali, Colombia, between March 2012 and June 2015. In order to evaluate the diagnostic performance of MSCT, the results obtained through this test were compared with those reported in the reference test (open surgery). Two readings of the imaging studies were performed by 2 radiologists. Intra- and interobserver agreement on the MSCT readings were analyzed using the Fleiss' Kappa coefficient.

Results:

MSCT had sensitivity and specificity of 94.4% and 46.8%, respectively. Its positive (PPV) and negative (NPV) predictive values were 44.7% and 94.8%, respectively. The positive likelihood ratio (LR+) was 1.7765, and the negative likelihood ratio (LR-) was 0.1186. Regarding interobserver agreement, Fleiss' Kappa coefficient between the first reading of both radiologists was 0.4425.

Conclusions:

MSCT specificity for diagnosing diaphragmatic injuries found in this study differs considerably from that reported in the literature. Considering the sensitivity, PPV and LR- values obtained in the present study, MSCT could be an important tool for the management of these patients since conservative treatment may be used in patients whose diaphragmatic injuries are not detected with this type of scan.

Palabras clave : Tomography; Tomography, X-Ray Computed; Tomography, Spiral Computed; Hernia, Diaphragmatic, Traumatic; Wounds, Gunshot (MeSH).

        · resumen en Español     · texto en Inglés     · Inglés ( pdf )