Deep Learning for Automated Detection and Localization of Traumatic Abdominal Solid Organ Injuries on CT Scans
Chi‐Tung ChengHou-Hsien LinChih-Po HsuHuan‐Wu ChenJen‐Fu HuangChi‐Hsun HsiehChih‐Yuan FuI‐Fang ChungChien‐Hung Liao
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Abstract Computed tomography (CT) is the most commonly used diagnostic modality for blunt abdominal trauma (BAT), significantly influencing management approaches. Deep learning models (DLMs) have shown great promise in enhancing various aspects of clinical practice. There is limited literature available on the use of DLMs specifically for trauma image evaluation. In this study, we developed a DLM aimed at detecting solid organ injuries to assist medical professionals in rapidly identifying life-threatening injuries. The study enrolled patients from a single trauma center who received abdominal CT scans between 2008 and 2017. Patients with spleen, liver, or kidney injury were categorized as the solid organ injury group, while others were considered negative cases. Only images acquired from the trauma center were enrolled. A subset of images acquired in the last year was designated as the test set, and the remaining images were utilized to train and validate the detection models. The performance of each model was assessed using metrics such as the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, positive predictive value, and negative predictive value based on the best Youden index operating point. The study developed the models using 1302 (87%) scans for training and tested them on 194 (13%) scans. The spleen injury model demonstrated an accuracy of 0.938 and a specificity of 0.952. The accuracy and specificity of the liver injury model were reported as 0.820 and 0.847, respectively. The kidney injury model showed an accuracy of 0.959 and a specificity of 0.989. We developed a DLM that can automate the detection of solid organ injuries by abdominal CT scans with acceptable diagnostic accuracy. It cannot replace the role of clinicians, but we can expect it to be a potential tool to accelerate the process of therapeutic decisions for trauma care.Keywords:
Youden's J statistic
Trauma Center
Ureteric injury is uncommon and mostly follows penetrating trauma or surgical injury. Ureteric rupture following blunt abdominal trauma is rare, there being only a few reported cases. The case described here, in which blunt abdominal trauma resulted in delayed intraperitoneal rupture, appears to be the first report of this type of injury in blunt trauma.
Blunt trauma
Penetrating Trauma
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In many European centers, patients with blunt abdominal trauma undergo screening sonography. This Dutch study examined the accuracy of sonography in 1,671 patients with blunt abdominal trauma seen in an emergency department (ED). Sonography was usually done by a radiologist shortly after the patient's …
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History and Objectives: Due to the prevalence of blunt abdominal trauma and availability, relative ease, economic consideration of sonographic applications and current controversy regarding sonography on diagnosis of intra-abdominal injury, the present study was carried on blunt abdominal traumatic patients at Rasul hospital in 1997-98 in order to assess the diagnostic power of sonography on intra-abdominal injury. Materials and Methods: A clinical diagnostic experimental study was performed and patient’s information and characteristics of the injury was recorded. Definite diagnosis of injuries was based on CT scan and laparotomy findings. PPV and NPV of sonography were defined. Results: Study covered 94 patients (76.6% male and 23.4% female) with age of 26.9±14.8 years. Car accident was the major cause of trauma. PPV and NPV of sonography for diagnosis of intra-abdominal organs injury were 76.5 and 84.8 respectively and for diagnosis of intra-abdominal free fluid were 100 and 96.6 respectively. Conclusion: Sonography has sufficient power for diagnosis of intraperitoneal free fluid however it dose not have sufficient power for diagnosis of intraperitoneal organs injury. Further study regarding the cause of low power is recommended.
Blunt trauma
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Diagnostic peritoneal lavage
Blunt trauma
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Experience with ultrasonography as a non-invasive imaging procedure for acute and follow-up diagnostic evaluation of blunt abdominal trauma was analysed in a retrospective study. Between 1980 and 1988, more than 2,000 ultrasonographic investigations were performed for blunt abdominal trauma; 246 patients were laparotomized. Retrospectively, false results based on ultrasonography were less than 1% of all cases, so that the sole use of ultrasonographic diagnosis and the non-use of peritoneal lavage seems justified in cases of blunt abdominal trauma. A number of figures illustrate typical cases.
Diagnostic peritoneal lavage
Abdominal ultrasonography
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Objective B ultrasonic examination in the diagnosis of blunt abdominal trauma in the application.Methods Retrospective analysis of our hospital in January 2008 and 2010 were treated in 110 patients with blunt abdominal trauma,B ultrasonic diagnosis and clinical diagnosis of the situation.Results Bultrasond diagnosis of blunt abdominal trauma in the accuracy rate was 90%.Conclusion B-ultrasound diagnosis of rupture of the abdominal organs and the clinical classification of high value.
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Clinical Diagnosis
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Objective To evaluate the clinical value of bedside sonography(BS)in blunt abdominal trauma.Methods A retrospectively study was done in 144 cases with blunt abdominal trauma.The clinical material of BS,operations and abdominal CT in blunt abdominal trauma were analyzed.Results Of the 144 cases,BS(+)in 112 cases,BS(-)in 32 cases.Abdomi- nal CT was performed in 108 cases.Laperotomy was performed in 88 cases.The coinci-dence rate of quality diagnosis of BS is 91.7%(132/144),and that of location diagnosis is 67.8%(76/112).In the group,124 cases were cured,20 cases were died.The overall mortality rate was 13.9%(20/144).Conclusion BS is a rapid and accurate method of qualitative diagnosis for blunt abdominal trauma and has partly value of location diagnosis.BS is an important method for closely monitoring the pa- tients receiving conservative treatment.
Blunt trauma
Conservative Treatment
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The isolated duodenal injury following blunt abdominal trauma is extremely rare.Because, duodenal injury is usually presented with other intra-abdominal organs injuries such as hepatic injury, pancreatic injury due to the anatomical position.So, We report a case of isolated duodenal injury following blunt abdominal trauma, and the discuss about the related article.[
Pancreatic injury
Blunt trauma
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Objective To improve the diagno stic and operational skills in blunt abdominal trauma due to traffic accidents. Methods Eighty nine cases of blunt abdominal trauma in our hos pital for the past 12 years were analyzed,and the data indicated that injuries h append more frequently on abdominal organs,such as spleen,liver and intestines. Results There were 81 survivals and 8 deaths.The mortality was 9%.Conclusion For patients with blunt abdominal trauma,early di agnosis is the key to a success rescue.The application of peritoneoscopy will im prove the diagnostic and therapeutic skills in blunt abdominal trauma.
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