Keywords:
Abdomen, Peritoneum, Contrast agents, CT, Percutaneous, Biopsy, Contrast agent-intravenous, Diagnostic procedure, Cancer, Infection, Cavitation
Authors:
F. Naz, W. A. Mirza; Karachi/PK
DOI:
10.26044/ecr2019/C-0699
Results
A total of 102 patients were identified with abdominal diseases and 98(96%) were included after applying the exclusion criteria.
Of those included,
62(63.2%) were found to be cases of disseminated TB and 36(36.7%) were diagnosed as malignant on histopathology.
Comparison of CT findings with histologic diagnosis was done (Table-1).
When comparing CT scan findings to histopathology,
4 findings on a CT scan showed statistical significance to diagnose TB over carcinomatosis; smooth thickening of the peritoneum,
abdominal mass,
lymph node necrosis and high density ascitic fluid.
Smooth thickening of the peritoneum showed good sensitivity and specificity (Table-2).
Multiple logistics regression showed sensitivity of 88.5% and specificity of 83.3 to diagnose peritoneal TB by a CT scan.
Table-1: Comparison of CT findings with Histological Diagnosis (N=98).
CT Findings
|
Histology
|
P value
|
|
Malignancy
(#of cases)
|
Tuberculosis
(#of cases)
|
|
Smooth Thickening (peritoneum)
Yes (%)
No (%)
|
5
20% (n=1)
80% (n=4)
|
47
77% (n= 36)
23% (n=11)
|
<0.001
|
Peritoneal Enhancement
Yes (%)
No (%)
|
36
100% (n=36)
0.0% (n=0)
|
60
98.4% (n=59)
1.6% (n=1)
|
0.736
|
Mass
Yes (%)
No (%)
|
13
38.4% (n = 5)
14.2% (n = 1)
|
07
61.5% (n=8)
88.5% (n=6)
|
0.013
|
Thickened Terminal Ileum
Yes (%)
No (%)
|
04
25% (n=1)
75% (n=3)
|
11
18% (n=2)
82% (n=9)
|
0.601
|
Lymphadenopathy
Yes (%)
No (%)
|
35
97.1% (n=34)
2.85% (n=1)
|
57
|
0.697
|
Lymph node necrosis
Yes (%)
No (%)
|
02
0.0% (n=0)
100% (n=2)
|
17
|
0.024
|
High density ascitic fluid
Yes (%)
No (%)
|
10
30% (n=3)
70% (n=7)
|
42
69% (n=29)
31% (n=13)
|
<0.001
|
Table-2: Sensitivity and Specificity of Specific CT Findings to Differentiate Tuberculosis From Carcinomatosis (N=98)
CT Findings
|
Sensitivity (%)
|
Specificity (%)
|
Smooth thickening (peritoneum)
|
77.0
|
86.1
|
Peritoneal Enhancement
|
98.4
|
0.0
|
Mass
|
11.5
|
63.9
|
Thickened terminal ileum
|
18 8
|
8.9
|
Lymphadenopathy
|
93.4
|
2.8
|
Lymph node necrosis
|
27.9
|
94.4
|
High density ascitic fluid
|
68.9
|
72.2
|