Comparison of Computed Tomography, Ultrasonography, and Gallium-67 Scanning in the Evaluation of Suspected Abdominal Abscess

Korobkin, Melvyn; Pw, Callen; Ra, Filly; Pb, Hoffer; Rr, Shimshak; Kressel, H Y

doi:10.1148/129.1.89

Cited by 114 publications

(17 citation statements)

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“…Other methods of diagnosing abdominal abscesses are gallium citrate scintigraphy and sonography [12][13][14][15][16][17]. Use of the former for the diagnosis of intraperitoneal inflammation, although highly sensitive, is unspecific because gallium citrate collects in all inflamed areas whether an exudate is present or not [18].…”

Section: Discussionmentioning

confidence: 99%

Computed tomography of intraperitoneal abscesses

Schneekloth

Terrier

Fuchs

1982

Gastrointest Radiol

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Eighty-seven patients with the clinical suspicion of an intraperitoneal abscess were examined by computed tomography. In 83 of these patients CT gave true positive or true negative results in reference to the diagnosis of local intraperitoneal fluids. The final diagnosis confirmed 28 abscesses in 26 patients. Most of these abscesses were in the left subphrenic space, the right subphrenic space, the right anterior subhepatic space, and the pelvis. The morphological criteria for intraperitoneal abscesses, shown by CT, are defined. Direct signs include form, impression on nonintestinal organs, density value, gas collection, pyogenic membrane, and infiltration in surrounding tissue. Indirect signs include ascites and pleural effusion and/or pulmonary infiltration. Differential diagnostic problems of intraperitoneal abscesses are discussed.

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Section: Discussionmentioning

confidence: 99%

Computed tomography of intraperitoneal abscesses

Schneekloth

Terrier

Fuchs

1982

Gastrointest Radiol

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“…Ultrasound is also valuable in the identification and localization of intra-abdominal fluid collections [2][3][4]. Fluid collections in the subphrenic space, the pericolic gutters, or in the pelvis are well visualized with ultrasound.…”

Section: Ultrasoundmentioning

confidence: 99%

“…In particular, CT is better that ultrasonography in obese patients and in patients with abdominal or thoracic dressing, where body habitus or physical surface obstacles obscure the view. Additionally, in the thoracic cavity, CT scanning is highly sensitive for diagnosis of pneumonias, pleural effusion, and loculated collections [4,[6][7].…”

Section: Computed Tomographymentioning

confidence: 99%

“…Subsequently, transferrin-and lactoferrin-bound 67 Ga particles concentrate in areas of infection by an assortment of mechanisms including hyperperfusion and increased vascular permeability. Certain bacteria also bind directly 67 Ga via mechanisms involving high-affinity siderophores and low-molecular weight chelates [4]. However, the long half-life (78 h) and wide organ distribution of 67 Ga results in a late time point (48-72 h) for optimum target-to-background ratio [25].…”

Section: Ady and Fongmentioning

confidence: 99%

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Imaging for Infection: From Visualization of Inflammation to Visualization of Microbes

Ady

Fong²

2014

Surgical Infections

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Background: With the development of high-resolution cross-sectional imaging, anatomic identification of most areas of infection has become routine. Imaging a site of infection allows for diagnosis and treatment. In the past, molecular imaging for infection involved mainly the use of radiolabeled leukocytes for functional targeting at infection sites. With the recent development of functional nuclear imaging, bacterial and viral metabolism can also be imaged directly for potential identification of early infection. Methods: Review of pertinent English-language literature. Results: Cross-sectional imaging is used routinely to identify and treat sources of infection in patients with fever, leukocytosis, or unexplained hemodynamic instability. Although ultrasound is preferred for the identification of biliary or hepatic sepsis, computed tomography (CT) has proved to be accurate for the identification and treatment of intra-abdominal fluid collections and abscesses. Biologic imaging is a non-invasive technique that identifies sites of infection in cases in which no definite abnormality is identified via cross-sectional imaging. This is made possible by imaging the accumulation of radioisotopes that have been attached to white blood cells or glucose. Biologic imaging is useful for the identification of anatomic sites where there is inflammation or high metabolic demand. However, a drawback of biologic imaging is that it is not specific for infection. Techniques that image microbes directly increase the specificity of imaging results significantly and can be used to quantify and track infectious processes. For example, radiolabeling of antimicrobial proteins and antibiotics is one technique that has been demonstrated to identify areas of infection accurately in animals but is not currently being used clinically in humans. With the advent of gene therapy, many researchers are inserting the herpes viral thymidine kinase gene into both viruses and bacteria. This allows for tracking of the infectious process by imaging the accumulation of radiolabeled thymidine analogues. Conclusion: This review summarizes standard imaging for infection as it is currently practiced clinically. We will also explore the promising new methods of microbial imaging that are likely to become standards in clinical care in the near future.

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“…This is despite advances in noninvasive testing such as ultrasound, computerized tomography, and nuclear medicine scans [1,7,10] and the increasing safety of mesenteric arteriography [3]. The inherent instability of many intensive-care-unit (ICU) patients makes the use of these diagnostic tools problematic.…”

mentioning

confidence: 99%

Diagnostic laparoscopy in critically ill intensive-care-unit patients

Bender

Talamini

1992

Surg Endosc

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The diagnosis of intraabdominal sepsis in critically ill intensive-care-unit patients remains a challenge. Diagnostic laparoscopy has been performed in seven such patients following admission for coronary artery bypass surgery, gram-negative sepsis, major burns, pneumonia, myocardial infarction, and post-pneumonectomy. Laparoscopy revealed acalculous cholecystitis in two patients (one removed laparoscopically), gangrenous colon in two, cirrhosis with liver infarction in one, and, in two patients, no pathology. Although five patients died postoperatively, none was related to the laparoscopy. There were no intraoperative complications and no known pathology was missed. Because of its ease and accuracy, diagnostic laparoscopy should be considered in all critically ill patients suspected of harboring intraabdominal pathology. Further studies are needed to fully establish its efficacy and safety.

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Comparison of Computed Tomography, Ultrasonography, and Gallium-67 Scanning in the Evaluation of Suspected Abdominal Abscess

Cited by 114 publications

References 0 publications

Computed tomography of intraperitoneal abscesses

Computed tomography of intraperitoneal abscesses

Imaging for Infection: From Visualization of Inflammation to Visualization of Microbes

Diagnostic laparoscopy in critically ill intensive-care-unit patients

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