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
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Atri, Mostafa
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Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, CanadaUniv Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, Canada
Atri, Mostafa
[1
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McGregor, Caitlin
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Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, CanadaUniv Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, Canada
McGregor, Caitlin
[1
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McInnes, Mathew
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Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, CanadaUniv Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, Canada
McInnes, Mathew
[1
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Power, Niall
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Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, CanadaUniv Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, Canada
Power, Niall
[1
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Rahnavardi, Katayoun
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Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, CanadaUniv Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, Canada
Rahnavardi, Katayoun
[1
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Law, Calvin
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Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Surg, Toronto, ON M4N 3M5, CanadaUniv Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, Canada
Law, Calvin
[2
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Kiss, Alex
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Univ Toronto, Sunnybrook Hlth Sci Ctr, ICES, Toronto, ON M4N 3M5, CanadaUniv Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, Canada
Kiss, Alex
[3
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[1] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, Toronto, ON M4N 3M5, Canada
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.
机构:
Columbia Univ, Coll Phys & Surg, St Lukes Roosevelt Hosp Ctr, Dept Radiol, New York, NY 10025 USAColumbia Univ, Coll Phys & Surg, St Lukes Roosevelt Hosp Ctr, Dept Radiol, New York, NY 10025 USA
机构:
Columbia Univ, Coll Phys & Surg, St Lukes Roosevelt Hosp Ctr, Dept Radiol, New York, NY 10025 USAColumbia Univ, Coll Phys & Surg, St Lukes Roosevelt Hosp Ctr, Dept Radiol, New York, NY 10025 USA