Multidetector helical CT in the evaluation of acute small bowel obstruction: Comparison of non-enhanced (no oral, rectal or IV contrast) and IV enhanced CT

被引:23
作者
Atri, Mostafa [1 ]
McGregor, Caitlin [1 ]
McInnes, Mathew [1 ]
Power, Niall [1 ]
Rahnavardi, Katayoun [1 ]
Law, Calvin [2 ]
Kiss, Alex [3 ]
机构
[1] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, Canada
[2] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Surg, Toronto, ON M4N 3M5, Canada
[3] Univ Toronto, Sunnybrook Hlth Sci Ctr, ICES, Toronto, ON M4N 3M5, Canada
关键词
Multidetector helical CT; Small bowel obstruction; CT technique; ACUTE ABDOMEN; COMPUTED-TOMOGRAPHY; ACUTE APPENDICITIS; DIAGNOSIS; MANAGEMENT; ISCHEMIA; IMPACT; EMERGENCY; EFFICACY; PAIN;
D O I
10.1016/j.ejrad.2008.04.011
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To compare accuracy of non-enhanced CT (NECT) (no oral or IV contrast) and enhanced CT (ECT) (IV enhanced only) to diagnose small bowel obstruction and evaluate reviewer's experience impact. Materials and methods: Ninety-nine adult patients underwent 105 NECT and ECT (6 patients had 2 examinations) on a four-detector CT. An abdominal radiologist, an abdominal imaging fellow, a second-year radiology resident retrospectively reviewed NECTs and ECTs separately and independently blinded to outcome. Discrepancy of diameter of proximal and distal small bowel +/- a transition was considered indication of mechanical bowel obstruction. Reference standard was surgery in 26 and chart review in 79. Results: Mechanical obstruction was present in 56% (59/105). The average sensitivity, specificity, negative and positive predictive and accuracy values for NECT were 88.1% (CI: 80-96%), 77% (Cl: 65-89%), 83.0% (CI: 72-95%), 83% (CI: 74-92%), and 83% (CI: 76-90%) with no significant difference between three reviewers. The corresponding numbers for ECT were 87.6% (Cl: 79-96%), 75% (Cl: 63-88%), 82.6.0% (CI: 71-94%), 82.1% (CI: 73-92%), and 82% (Cl: 75-90%) (p > 0.5). Area under curve (AUC) of ROC curves of three reviewers did not show significant statistical difference (p > 0.5). Conclusions: NECT and ECT have comparable accuracy to diagnose mechanical small bowel obstruction and can be interpreted by reviewers with different levels of expertise. (C) 2008 Published by Elsevier Ireland Ltd.
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页码:135 / 140
页数:6
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