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Cutoff CT value can identify upper gastrointestinal bleeding on postmortem CT: Development and validation study.

Naomasa Okimoto1, Masanori Ishida1, Wataru Gonoi1

  • 1Department of Radiology, Graduate School of Medicine, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan.

Plos One
|June 7, 2024
PubMed
Summary
This summary is machine-generated.

Postmortem CT scans can diagnose upper gastrointestinal bleeding (UGIB) using a specific Hounsfield unit (HU) cutoff. A threshold of ≥27.7 HU, combined with solid gastrointestinal content, provides valid and reproducible diagnostic criteria for UGIB.

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Area of Science:

  • Forensic Radiology
  • Medical Imaging
  • Gastroenterology

Background:

  • Establishing accurate diagnostic criteria for upper gastrointestinal bleeding (UGIB) in postmortem examinations is crucial.
  • Postmortem computed tomography (PMCT) offers a non-invasive method for evaluating internal injuries and conditions.

Purpose of the Study:

  • To determine reliable diagnostic criteria for UGIB using noncontrast PMCT.
  • To validate these criteria in a separate patient cohort.

Main Methods:

  • A case-control study involving patients with and without autopsy-proven UGIB.
  • Patients underwent noncontrast PMCT and conventional autopsy.
  • Imaging findings, including CT values of upper gastrointestinal contents, were analyzed in derivation and validation sets.

Main Results:

  • The optimal cutoff CT value for diagnosing UGIB was ≥27.7 Hounsfield units (HU), with high sensitivity and specificity in both derivation and validation sets.
  • A mean CT value of 48.2 HU was observed in UGIB cases versus 22.8 HU in non-UGIB cases.
  • Combining the CT value cutoff with findings of solid gastrointestinal content improved specificity but reduced sensitivity in the validation set.

Conclusions:

  • A noncontrast PMCT cutoff CT value of ≥27.7 HU is a valid and reproducible criterion for diagnosing UGIB.
  • The presence of solid gastrointestinal content further enhances the specificity of PMCT in diagnosing UGIB.