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The sensitivity, specificity and predictive values of post mortem computed tomography in detecting liver and splenic injury due to road traffic accident
Norzailin Abu Bakar1, Noor Azman Shairi2, Mohammad Helmi Mohammad Nor3, Khairul Anuar Zainon4.
Objective: The purpose of the study was to determine the
sensitivity, specificity, positive predictive value (PPV) and
negative predictive value (NPV) of post mortem computed
tomography (PMCT) in detecting liver and splenic injuries
due to road traffic accidents.
Material & Method: 61 road traffic accidental death cases
underwent both PMCT and conventional autopsy. The
imaging findings were compared to the conventional
autopsy findings.
Result: The sensitivity, specificity, PPV and NPV for liver
injuries in PMCT was 71%, 82%, 68% and 85% while that of
splenic injuries was 73%, 80%, 55% and 90% respectively.
The accuracy of PMCT scan was 79% for both liver and
splenic injuries. There is strong association between lower
left ribs fracture and splenic injury (p=0.005) and significant
association between positive liver and splenic PMCT finding
and intraabdominal fatal injury (p=0.037).
Conclusion: In conclusion PMCT has high specificity and
NPV for liver and splenic injuries; however the sensitivity
and PPV are low. The overall accuracy is not high enough to
enable PMCT to be used as a replacement for conventional
autopsy; however it is a useful complementary examination
and has potential to be used as decision making tool for
selective internal autopsy
Affiliation:
- National University of Malaysia, Malaysia
- KPJ Healthcare University College, Malaysia
- Hospital Kuala Lumpur, Malaysia
- Hospital Kuala Lumpur, Malaysia
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