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The recognition of previous abdominal surgery by computed tomography
J M Somers1, S G Pollard, A K Dixon
1Department of Radiology, Addenbrooke's Hospital, Cambridge, England.
Journal of Computer Assisted Tomography
|January 1, 1991
Summary
Radiologists often miss surgical scars on abdominopelvic CT scans, even large ones. Accurate surgical history is crucial for interpreting these important diagnostic imaging studies.
Area of Science:
- Radiology
- Surgical Imaging
Background:
- Abdominopelvic computed tomography (CT) interpretation requires awareness of prior surgical interventions.
- Surgical scars may indicate underlying anatomical alterations relevant to CT findings.
Purpose of the Study:
- To assess the reliability of detecting previous surgery solely through abdominopelvic CT image review.
- To determine the accuracy of radiologists in identifying surgical scars on CT scans without clinical information.
Main Methods:
- Fifty consecutive patients undergoing abdominopelvic CT were evaluated.
- One radiologist assessed for scars and confirmed with patients.
- A second radiologist, blinded to clinical data, reviewed CT images for evidence of prior surgery.
Main Results:
- Initial scar recognition accuracy was only 51%, improving to 63% on retrospective review.
- Large paramedian scars were frequently missed.
- Older scars were less likely to be detected than recent ones.
Conclusions:
- Radiographic detection of surgical scars on abdominopelvic CT is unreliable.
- Clinical history regarding previous surgeries is essential for accurate CT interpretation.
- Missed surgical evidence can lead to misinterpretation of abdominopelvic CT scans.