title: Comparison of diagnostic performance between single- and multiphasic contrast-enhanced abdominopelvic computed tomography in patients admitted to the emergency department with abdominal pain: potential radiation dose reduction.
abstract: OBJECTIVE
  To evaluate feasibility of radiation dose reduction by optimal phase selection of computed tomography (CT) in patients who visited the emergency department (ED) for abdominal pain.
  
  
  METHODS
  We included 253 patients who visited the ED for abdominal pain. They underwent multiphasic CT including precontrast, late arterial phase (LAP), and hepatic venous phase (HVP). Three image sets (HVP, precontrast + HVP, and precontrast + LAP + HVP) were reviewed. Two reviewers determined the most appropriate diagnosis with five-point confidence scale. Diagnostic performances were compared among image sets by weighted-least-squares method or DeLong's method. Linear mixed model was used to assess changes of diagnostic confidence and radiation dose.
  
  
  RESULTS
  There was no difference in diagnostic performance among three image sets, although diagnostic confidence level was significantly improved after review of triphasic images compared with both HVP images only or HVP with precontrast images (confidence scale, 4.64 ± 0.05, 4.66 ± 0.05, and 4.76 ± 0.04 in the order of the sets; overall P = 0.0008). Similar trends were observed in the subgroup analysis for diagnosis of pelvic inflammatory disease and cholecystitis.
  
  
  CONCLUSIONS
  There is no difference between HVP-CT alone and multiphasic CT for the diagnosis of causes of abdominal pain in patients admitted to the ED without prior chronic disease or neoplasia.
  
  
  CONCLUSIONS
  • There was no difference in diagnostic performance of HVP CT and multiphasic CT. • The diagnostic confidence level was improved after review of the LAP images. • HVP CT can achieve diagnostic performance similar to that of multiphasic CT, while minimizing radiation.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
authors.forename: Shin Hye
authors.initials: SH
authors.lastname: Hwang
authors.forename: Je Sung
authors.initials: JS
authors.lastname: You
authors.forename: Mi Kyong
authors.initials: MK
authors.lastname: Song
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Myeong-Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Yong Eun
authors.initials: YE
authors.lastname: Chung
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010388:Pelvis / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media