Research on Diagnostic Accuracy and Related Factors of CT for Intra-Thoracic Anastomotic Leak

DOI

10.2991/icmmct-17.2017.264How to use a DOI?

Keywords

anastomotic leak, tomography; contrast agent spillover

Abstract

Objective: To evaluate the accuracy of CT in the diagnosis of esophageal fistula (Anastomotic leakage). Methods: Retrospective analysis of 186 cases of suspected postoperative esophageal postoperative intracavitary AL patients, 70 cases take oral 60% compound diatrizoate (contrast agent) CT examination and 116 cases take oral contrast agent CT examination. The CT images of oral or non-oral contrast agents were observed by two imaging physicians (Physician 1 and Physician 2, respectively). Kappa test was used to evaluate the consistency of two physicians in diagnosing AL. The variables related to AL were screened by Fisher exact test, Pearson 2 test and univariate analysis. Multivariate logistic regression analysis was used to confirm the reliable signs of AL. Results AL49 cases, no AL137 cases. The diagnostic sensitivity and specificity of AL were 79.6%, 83.7%, 83.9% and 84.7% respectively. The positive predictive value was significantly improved by oral contrast (from 40.6% to 89.7%, from 39.4% to 96.5%, P <0.05). The sensitivity and specificity were 83.3%, 86.7%, 97.5% and 97.5% respectively. There was also a high correlation between the accumulation of gas and anastomotic effusion. The univariate analysis showed that all of them were related to AL (P <0.05). Multivariate analysis showed independent correlation of contrast agent spillover. Conclusion CT can be a comprehensive assessment of postoperative esophageal AL-related signs, CT combined with oral contrast agent can improve the diagnostic accuracy and the contrast agent spillover is the most reliable signs.

Copyright

© 2017, the Authors. Published by Atlantis Press.

Open Access

This is an open access article distributed under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - CONF
AU  - Caiyun Liu
PY  - 2017/04
DA  - 2017/04
TI  - Research on Diagnostic Accuracy and Related Factors of CT for Intra-Thoracic Anastomotic Leak
BT  - Proceedings of the 2017 5th International Conference on Machinery, Materials and Computing Technology (ICMMCT 2017)
PB  - Atlantis Press
SP  - 1374
EP  - 1379
SN  - 2352-5401
UR  - https://doi.org/10.2991/icmmct-17.2017.264
DO  - 10.2991/icmmct-17.2017.264
ID  - Liu2017/04
ER  -