Diagnosis of diaphragmatic trauma with helical CT in a swine model

R. Scott Israel, Patricia A. McDaniel, Steven Primack, Christopher J. Salmon, Robert L. Fountain, D. Bradley Koslin

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to determine whether diaphragmatic injury can be accurately diagnosed with helical CT in a swine model. The hypothesis of our study was that thin-section helical CT with sagittal and coronal reformations can reliably detect injury of the diaphragm. MATERIALS AND METHODS. The study was performed in a swine model because of the similarity of the swine thorax to the human thorax. Ten swine had a limited abdominal helical CT (enteral contrast; 3-mm collimation; pitch, 1) before and after surgical creation of a 6-cm posterolateral laceration in the left hemidiaphragm. A repeat scan was obtained after 5 cm of gastric fundus was sutured through the laceration. The gastric fundus was used because it is the most commonly herniated viscus in human diaphragmatic injury. No IV contrast was used. Control, laceration, and herniation scans were reconstructed with 1.0-mm overlap and reformatted in axial, sagittal, and coronal planes. Three observers scored each reformation as control or injury (defined as laceration or herniation) in a blinded and randomized fashion. RESULTS. Using helical CT, the observers were able to distinguish diaphragmatic injury from controls (p <.0001). The sensitivity and specificity were 92% and 87%, respectively, for sagittal reformations; 85% and 87%, respectively, for coronal reformations; and 73% and 80%, respectively, for axial reformations. Sagittal reformations proved superior to coronal or axial reformations (p = .01). The results were independent of individual observers: We found no significant difference in accuracy among the three observers. CONCLUSION. Helical CT can accurately detect diaphragmatic injury in a swine model.

Original languageEnglish (US)
Pages (from-to)637-641
Number of pages5
JournalAmerican Journal of Roentgenology
Volume167
Issue number3
StatePublished - 1996

Fingerprint

Spiral Computed Tomography
Swine
Lacerations
Wounds and Injuries
Gastric Fundus
Thorax
Viscera
Diaphragm
Small Intestine
Sensitivity and Specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Scott Israel, R., McDaniel, P. A., Primack, S., Salmon, C. J., Fountain, R. L., & Bradley Koslin, D. (1996). Diagnosis of diaphragmatic trauma with helical CT in a swine model. American Journal of Roentgenology, 167(3), 637-641.

Diagnosis of diaphragmatic trauma with helical CT in a swine model. / Scott Israel, R.; McDaniel, Patricia A.; Primack, Steven; Salmon, Christopher J.; Fountain, Robert L.; Bradley Koslin, D.

In: American Journal of Roentgenology, Vol. 167, No. 3, 1996, p. 637-641.

Research output: Contribution to journalArticle

Scott Israel, R, McDaniel, PA, Primack, S, Salmon, CJ, Fountain, RL & Bradley Koslin, D 1996, 'Diagnosis of diaphragmatic trauma with helical CT in a swine model', American Journal of Roentgenology, vol. 167, no. 3, pp. 637-641.
Scott Israel R, McDaniel PA, Primack S, Salmon CJ, Fountain RL, Bradley Koslin D. Diagnosis of diaphragmatic trauma with helical CT in a swine model. American Journal of Roentgenology. 1996;167(3):637-641.
Scott Israel, R. ; McDaniel, Patricia A. ; Primack, Steven ; Salmon, Christopher J. ; Fountain, Robert L. ; Bradley Koslin, D. / Diagnosis of diaphragmatic trauma with helical CT in a swine model. In: American Journal of Roentgenology. 1996 ; Vol. 167, No. 3. pp. 637-641.
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abstract = "OBJECTIVE. The purpose of this study was to determine whether diaphragmatic injury can be accurately diagnosed with helical CT in a swine model. The hypothesis of our study was that thin-section helical CT with sagittal and coronal reformations can reliably detect injury of the diaphragm. MATERIALS AND METHODS. The study was performed in a swine model because of the similarity of the swine thorax to the human thorax. Ten swine had a limited abdominal helical CT (enteral contrast; 3-mm collimation; pitch, 1) before and after surgical creation of a 6-cm posterolateral laceration in the left hemidiaphragm. A repeat scan was obtained after 5 cm of gastric fundus was sutured through the laceration. The gastric fundus was used because it is the most commonly herniated viscus in human diaphragmatic injury. No IV contrast was used. Control, laceration, and herniation scans were reconstructed with 1.0-mm overlap and reformatted in axial, sagittal, and coronal planes. Three observers scored each reformation as control or injury (defined as laceration or herniation) in a blinded and randomized fashion. RESULTS. Using helical CT, the observers were able to distinguish diaphragmatic injury from controls (p <.0001). The sensitivity and specificity were 92{\%} and 87{\%}, respectively, for sagittal reformations; 85{\%} and 87{\%}, respectively, for coronal reformations; and 73{\%} and 80{\%}, respectively, for axial reformations. Sagittal reformations proved superior to coronal or axial reformations (p = .01). The results were independent of individual observers: We found no significant difference in accuracy among the three observers. CONCLUSION. Helical CT can accurately detect diaphragmatic injury in a swine model.",
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