Based on recent studies, there is potential value in employment of artificial intelligence techniques to enhance the value of abdominal US in the setting of sepsis, but this discussion is beyond the scope of this topic. Sorenson et al [18] performed a retrospective review of 221 patients with first-time bacteremia suspected to be urosepsis. Of these, 116/221 (52%) of the patients underwent further evaluation with either abdominal US or abdomen/pelvis CT. Major abnormalities were found in 37/115 (32%) of patients and most commonly included pyonephrosis and renal calculi. Of these, 15/115 (13%) of the patients underwent urological intervention as a result of imaging findings. Follow-up of the 105 patients who did not undergo initial imaging revealed that 10/105 (9.5%) Sepsis of the patients were readmitted the following year with urosepsis; of these patients, imaging by US or CT was indicated for 6/10, and a major abnormality was detected in 3/6 imaged patients. Hoddick et al [13] performed a prospective study of 12 patients with urosepsis who were evaluated with both US and CT. Of these, 6/12 patients had renal abscesses, of whom 6/6 (100%) of the patients were identified on both US and contrast-enhanced CT. One patient had multiple perirenal abscesses, and another patient had a gas-forming perinephric abscess that were both missed by US but seen on CT. WBC Scan Abdomen and Pelvis There are no data to support the use of white blood cell (WBC) scan abdomen and pelvis as an initial diagnostic imaging study added in the diagnosis of sepsis. Variant 4: Suspected or confirmed sepsis. No specific symptoms suggestive of origin, or symptoms cannot be assessed. Initial imaging. CT plays an important role in the evaluation of patients with suspected sepsis because of its high PPV [6] when performed as either an initial or follow-up imaging study, which often leads to a change in management [7]. Septic foci are most commonly detected in the chest, abdomen, or pelvis.
Sepsis. Based on recent studies, there is potential value in employment of artificial intelligence techniques to enhance the value of abdominal US in the setting of sepsis, but this discussion is beyond the scope of this topic. Sorenson et al [18] performed a retrospective review of 221 patients with first-time bacteremia suspected to be urosepsis. Of these, 116/221 (52%) of the patients underwent further evaluation with either abdominal US or abdomen/pelvis CT. Major abnormalities were found in 37/115 (32%) of patients and most commonly included pyonephrosis and renal calculi. Of these, 15/115 (13%) of the patients underwent urological intervention as a result of imaging findings. Follow-up of the 105 patients who did not undergo initial imaging revealed that 10/105 (9.5%) Sepsis of the patients were readmitted the following year with urosepsis; of these patients, imaging by US or CT was indicated for 6/10, and a major abnormality was detected in 3/6 imaged patients. Hoddick et al [13] performed a prospective study of 12 patients with urosepsis who were evaluated with both US and CT. Of these, 6/12 patients had renal abscesses, of whom 6/6 (100%) of the patients were identified on both US and contrast-enhanced CT. One patient had multiple perirenal abscesses, and another patient had a gas-forming perinephric abscess that were both missed by US but seen on CT. WBC Scan Abdomen and Pelvis There are no data to support the use of white blood cell (WBC) scan abdomen and pelvis as an initial diagnostic imaging study added in the diagnosis of sepsis. Variant 4: Suspected or confirmed sepsis. No specific symptoms suggestive of origin, or symptoms cannot be assessed. Initial imaging. CT plays an important role in the evaluation of patients with suspected sepsis because of its high PPV [6] when performed as either an initial or follow-up imaging study, which often leads to a change in management [7]. Septic foci are most commonly detected in the chest, abdomen, or pelvis.