Computed tomography to exclude necrotizing soft tissue infection: not quite ready for prime time?: comment on 'Diagnosis of necrotizing soft tissue infections by computed tomography'.

摘要

Dr Zacharias and colleagues have proposed that a negative CT result can reliably exclude the presence of NSTI, providing that a 16- or 64-section helical CT is used and intravenous contrast given. Although they report no false-negative CT results, scan in a patient with a surgically confirmed NSTI was "equivocal" and CT needed to be repeated within 12 hours. Such an event might be considered a false-negative result in the purest sense and therefore could have altered the reported results. Although it has been described that repeat CT imaging may have a role in the diagnosis of NSTI in select patients, the need for an additional contrast load in the face of infection and end-organ dysfunction needs to be carefully weighed against any potential benefits.