Heroin body packing: clearly discerning drug packets using CT.
BACKGROUND
To determine if heroin body packing has occurred using computed tomography (CT), and to evaluate the role of CT in screening such cases.


METHODS
We collected 158 cases of suspected drug packers' imaging materials (all underwent CT, 42 cases were imaged using plain x-ray film) from September 5, 2005 to April 23, 2008. Abdominal-pelvic CT appearances (shape, size, number, location and density) and abdominal plain x-ray film manifestations were retrospectively observed for those who were finally confirmed as heroin body packers through the passing of evacuated drug packets.


RESULTS
Among 158 cases of suspected drug packers in our study, 124 cases were finally diagnosed as heroin body packers. This was consistent with the CT results. However, there were 2 false-negative cases of abdominal imaging taken with plain x-ray film. All of the evacuated heroin body packets were produced mechanically. CT and plain film characteristic findings included the presence of uniform shape, varied density, and well-defined round or ovoid intra-luminal foreign-body shadows arranged closely along the gastrointestinal (GI) tract and/or vagina. We also found that the "air-ring sign" and "onion sign" were valuable characteristics that were seen on the CT scan, which helped to positively confirm the detection of heroin packets.


CONCLUSIONS
Heroin body packing has clearly defined diagnostic features that can be seen with CT. Furthermore, conventional abdominal-pelvic CT is the imaging modality of choice in the evaluation of suspected body packers.
Imaging Centre, Nanfang Hospital, The Southern Medical University, Guangzhou, Guangdong Province, China.
Rui-Meng
RM
Yang
Long
L
Li
Jie
J
Feng
Sheng-Sheng
SS
Lai
Bing-Quan
BQ
Lin
Tian
T
Yu
Xiang-Hua
XH
Ye
Yi-Kai
YK
Xu
D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging*; D003932:Heroin; D006801:Humans; D013287:Illicit Drugs; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014621:Vagina / Q000000981:diagnostic imaging
D013287:Illicit Drugs; D003932:Heroin