Diagnosis of Necrotizing Soft Tissue Infections by Computed Tomography

Abstract

Patients with necrotizing soft tissue infections (NSTIs) have mortality rates that range from 25% to 75%; therefore, this disease remains a therapeutic challenge.^1-7 Treatment delays are frequent and in part owing to inadequate diagnostic tests. Computed tomography (CT) scanning has been considered inaccurate for the diagnosis of NSTI based on studies with small sample sizes and old CT technology.^2,7,8 Magnetic resonance imaging (MRI) has a higher sensitivity but still low specificity and is not always available around the clock.^9-12 Liberal surgical exploration has been recommended to prevent treatment delays but results in unnecessary interventions, pain, inconvenience, and expenses. The evolution of CT technology has allowed better definition of tissues and interpretation of images. Our hypothesis is that the new 16- and 64-section CT scanners can accurately diagnose NSTI and identify patients who require surgical intervention. The objective of this study is to calculate the sensitivity and specificity of 16- and 64-section CT for diagnosing NSTI.