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Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach

The aim of this investigation was to evaluate predictive CT imaging features and clinical parameters to distinguish infected from sterile fluid collections. Detection of infectious agents by advanced microbiological analysis was used as the reference standard. From April 2018 to October 2019, all pa...

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Autores principales: Skusa, Christopher, Skusa, Romy, Wohlfarth, Moritz, Warnke, Philipp, Podbielski, Andreas, Bath, Kristina, Groß, Justus, Schafmayer, Clemens, Frickmann, Hagen, Weber, Marc-André, Hahn, Andreas, Meinel, Felix G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870876/
https://www.ncbi.nlm.nih.gov/pubmed/35204585
http://dx.doi.org/10.3390/diagnostics12020493
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author Skusa, Christopher
Skusa, Romy
Wohlfarth, Moritz
Warnke, Philipp
Podbielski, Andreas
Bath, Kristina
Groß, Justus
Schafmayer, Clemens
Frickmann, Hagen
Weber, Marc-André
Hahn, Andreas
Meinel, Felix G.
author_facet Skusa, Christopher
Skusa, Romy
Wohlfarth, Moritz
Warnke, Philipp
Podbielski, Andreas
Bath, Kristina
Groß, Justus
Schafmayer, Clemens
Frickmann, Hagen
Weber, Marc-André
Hahn, Andreas
Meinel, Felix G.
author_sort Skusa, Christopher
collection PubMed
description The aim of this investigation was to evaluate predictive CT imaging features and clinical parameters to distinguish infected from sterile fluid collections. Detection of infectious agents by advanced microbiological analysis was used as the reference standard. From April 2018 to October 2019, all patients undergoing CT-guided drainages were prospectively enrolled, if drainage material volume was at least 5 mL. Univariate analysis revealed attenuation (p = 0.001), entrapped gas (p < 0.001), fat stranding (p < 0.001), wall thickness (p < 0.001) and enhancement (p < 0.001) as imaging biomarkers and procalcitonin (p = 0.003) as clinical predictive parameters for infected fluid collections. On multivariate analysis, attenuation > 10 HU (p = 0.038), presence of entrapped gas (p = 0.027) and wall enhancement (p = 0.028) were independent parameters for distinguishing between infected and non-infected fluids. Gas entrapment had high specificity (93%) but low sensitivity (48%), while wall enhancement had high sensitivity (91%) but low specificity (50%). CT attenuation > 10 HU showed intermediate sensitivity (74%) and specificity (70%). Evaluation of the published proposed scoring systems did not improve diagnostic accuracy over independent predictors in our study. In conclusion, this prospective study confirmed that CT attenuation > 10 HU, entrapped gas and wall enhancement are the key imaging features to distinguish infected from sterile fluid collections on CT.
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spelling pubmed-88708762022-02-25 Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach Skusa, Christopher Skusa, Romy Wohlfarth, Moritz Warnke, Philipp Podbielski, Andreas Bath, Kristina Groß, Justus Schafmayer, Clemens Frickmann, Hagen Weber, Marc-André Hahn, Andreas Meinel, Felix G. Diagnostics (Basel) Article The aim of this investigation was to evaluate predictive CT imaging features and clinical parameters to distinguish infected from sterile fluid collections. Detection of infectious agents by advanced microbiological analysis was used as the reference standard. From April 2018 to October 2019, all patients undergoing CT-guided drainages were prospectively enrolled, if drainage material volume was at least 5 mL. Univariate analysis revealed attenuation (p = 0.001), entrapped gas (p < 0.001), fat stranding (p < 0.001), wall thickness (p < 0.001) and enhancement (p < 0.001) as imaging biomarkers and procalcitonin (p = 0.003) as clinical predictive parameters for infected fluid collections. On multivariate analysis, attenuation > 10 HU (p = 0.038), presence of entrapped gas (p = 0.027) and wall enhancement (p = 0.028) were independent parameters for distinguishing between infected and non-infected fluids. Gas entrapment had high specificity (93%) but low sensitivity (48%), while wall enhancement had high sensitivity (91%) but low specificity (50%). CT attenuation > 10 HU showed intermediate sensitivity (74%) and specificity (70%). Evaluation of the published proposed scoring systems did not improve diagnostic accuracy over independent predictors in our study. In conclusion, this prospective study confirmed that CT attenuation > 10 HU, entrapped gas and wall enhancement are the key imaging features to distinguish infected from sterile fluid collections on CT. MDPI 2022-02-14 /pmc/articles/PMC8870876/ /pubmed/35204585 http://dx.doi.org/10.3390/diagnostics12020493 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Skusa, Christopher
Skusa, Romy
Wohlfarth, Moritz
Warnke, Philipp
Podbielski, Andreas
Bath, Kristina
Groß, Justus
Schafmayer, Clemens
Frickmann, Hagen
Weber, Marc-André
Hahn, Andreas
Meinel, Felix G.
Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach
title Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach
title_full Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach
title_fullStr Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach
title_full_unstemmed Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach
title_short Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach
title_sort imaging and clinical parameters for distinction between infected and non-infected fluid collections in ct: prospective study using extended microbiological approach
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870876/
https://www.ncbi.nlm.nih.gov/pubmed/35204585
http://dx.doi.org/10.3390/diagnostics12020493
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