Abstract
Purpose: The purpose of this study has been to evaluate the diagnostic information contained in the CT scout view in the detection of body packing. Materials and methods: Retrospect analysis of 43 CT scans between July 2011 and June 2013 in asymptomatic suspects of body packing (29 men, 14 females, mean age 38 ± 9 years). Results: A total of 11 positive cases of body packing were identified. In 10 (91%) of the cases packets were relatively large and spares in number (3 or less); in 7 (64%) a single packet has been identified. 6 (55%) of the packets were located rectally, 4 (36%) vaginally and in 1 (9%) case multiple small packets of approximately 1 cm in size were found to have been ingested orally. Maximum and minimum diameters were 5.9 ± 3 cm and 2.9 ± 1.4 cm, respectively. The mean weight of packets was 7.5 ± 4.2 g (range 2 - 54 g). In 73% (n = 8) heroin had been detected; other drugs such as cocaine (n = 1) and cannabis (n = 1) were encountered once, respectively. One packet was identified retrospectively and its content could therefore not be identified. The average effective dose was 3.8 ± 2.1 mSv for CT, of that 0.12 ± 0.01 mSv was required for the CT scout view. Conclusion: If CT scout view were treated as a diagnostic image, some CT scans may be omitted, thereby maintaining streamlined operations and achieving further dose reduction jointly in the workup of body packing.
Highlights
IntroductionSince imaging characteristics of body packing (BP) vary it remains difficult to prove or exclude BP as it is not limited to a single substance (e.g. heroin, cocaine) or mode of packaging (e.g. condom, foil wrapping) [3]
If CT scout view were treated as a diagnostic image, some CT scans may be omitted, thereby maintaining streamlined operations and achieving further dose reduction jointly in the workup of body packing
We evaluated the agreement of each CT scan and its corresponding CT scout view with the Cohen’s kappa coefficient
Summary
Since imaging characteristics of BP vary it remains difficult to prove or exclude BP as it is not limited to a single substance (e.g. heroin, cocaine) or mode of packaging (e.g. condom, foil wrapping) [3]. A further complicating factor can be the localisation of the packets within the gastrointestinal tract and accompanying superimposed structures such as gas, compacted stool or bony structures, each depending on the time and mode of application (oral, rectal, vaginal). As a consequence, imaging characteristics differ and diagnostic performance of both X-ray and CT vary, deeming a plain X-ray often insufficient
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