Poster Author of 1 e-Poster
SE-035 - Can CT replace endoscopy after caustic ingestion? Inter-observer agreement and diagnostic accuracy in staging esophagogastric damage
Author of 1 Presentation
SE-035 - Can CT replace endoscopy after caustic ingestion? Inter-observer agreement and diagnostic accuracy in staging esophagogastric damage
Abstract
Purpose
Recent studies reported that contrast-enhanced CT may perform better that endoscopy in detecting transmural esophagogastric injuries after caustic ingestion. The aim of this study was to evaluate the inter-observer agreement and the diagnostic accuracy of CT in staging esophagogastric damage after caustic ingestion.
Material and methods
15 patients were admitted at our Emergency Department after caustic ingestion. All patients underwent contrast-enhanced CT and endoscopy. CT examinations were retrospectively and independently evaluated by 2 senior radiologists and 2 radiology residents; inter-observer agreement for the grading of esophageal damage was calculated according to Cohen’s kappa. Diagnostic accuracy of CT was calculated using endoscopy as the gold standard.
Results
Inter-observer agreement for senior/young readers was .277/.156 and .625/.095 for esophageal and gastric damage, respectively. The mean sensitivity, specificity and accuracy of CT in detecting transmural esophageal necrosis were 37.5%, 79.5%, and 71.8%; the mean sensitivity, specificity and accuracy of CT in detecting transmural gastric necrosis were 14.3%, 97%, and 58.3%.
Conclusion
According to our results CT cannot reliably replace emergency endoscopy in staging esophagogastric damage after caustic ingestion.