title: Differential diagnosis of pelvic cystic lesions caused by hemorrhage from inflammatory abscess using CT attenuation in women with acute abdomen.
abstract: To determine the efficacy of computed tomography (CT) attenuation of cystic lesions measured on an image browsing system to distinguish abscess from hematoma in women with acute abdomen. The medical records of female patients of reproductive age with acute abdomen who were treated over a 7-year period in a single center and who had undergone laparotomy or laparoscopic surgery and preoperative pelvic CT scanning were retrospectively analyzed to identify those with hematoma or abscess cyst formation. Nineteen patients with tubo-ovarian abscess (abscess group) and six patients with hematoma (hematoma group) formation in the pelvis were included in the analysis. The preoperative CT images of the tubo-ovarian cyst were retrospectively investigated on the basis of cyst attenuation. CT attenuation of the cyst measured by both two gynecologists could be used to clearly distinguish inflammatory disease with abscess formation from bleeding disease with hematoma. CT attenuation on a picture archiving and communication system can distinguish hematoma from abscess in women with acute abdomen. This may significantly contribute to making differential diagnosis without interpretation by a medical radiologist.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kajihara
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Miki
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Hirabayashi
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Shintani
authors.affiliation: Department of Radiology, Saitama Medical University, Iruma-gun, Saitama, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Niitsu
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishihara
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Itakura
keywords: CT attenuation; abscess; acute abdomen; differential diagnosis; hematoma