E5436. Multidetector CT Scan for Diagnosing Penetrating Diaphragmatic Injuries: A Comprehensive Review and Meta-Analysis
  1. Amir Hassankhani; University of Southern California
  2. Melika Amoukhteh; University of Southern California
  3. Ali Gholamrezanezhad; University of Southern California
The identification and management of penetrating diaphragmatic injuries presents intricate challenges. Although stable patients benefit from CT scans, concerns persist about overlooked injuries and complications in nonsurgically treated cases. This research aims to delve into the effectiveness of multidetector CT scan (MDCT) in the detection of diaphragmatic injuries resulting from penetrating trauma.

Materials and Methods:
A systematic review and meta-analysis was executed in accordance with established protocols. The investigation involved querying PubMed, Scopus, Web of Science, and Embase databases until July 6, 2023. Eligible studies were those that reported the diagnostic accuracy of MDCT in identifying penetrating diaphragmatic injuries. Pertinent data points were extracted and subjected to analysis utilizing STATA software.

The study encompassed nine articles, involving 294 patients with confirmed penetrating diaphragmatic injuries established via surgical procedures. The aggregated diagnostic performance of MDCT unveiled a sensitivity of 74% (95% CI: 56–87%) and specificity of 92% (95% CI: 79–97%), although notable heterogeneity was detected in both sensitivity and specificity across the examined studies. The Fagan plot demonstrated a direct correlation between elevated pretest probabilities and heightened positive posttest probabilities, concerning the diagnosis of penetrating diaphragmatic injuries through MDCT. However, even with negative outcomes, a marginal probability of injury persisted, particularly in cases with elevated pretest probabilities.

This study highlights the efficacy of MDCT in detecting diaphragmatic injuries resulting from penetrating trauma, characterized by a moderate to high degree of diagnostic accuracy. Nonetheless, addressing the observed heterogeneity calls for larger sample sizes, collaborative efforts across multiple centers, and prospective study designs. Such measures would augment comprehension and consistency in the diagnostic potential of MDCT within this context.