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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-8870876 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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