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Date Published: 08/07/2022
Online Published: 08/07/2022
Abstract Views: 313
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DOI: https://doi.org/10.55046/vjrnm.34.573.2019
Issue
No. 34 (2019)
Section
Scientific research
How to Cite
Vu, T. T. H., & Vo, T. D. (2022). CT findings for diagnosis of bowel ischemia and necrosis in closed-loop small-bowel obstruction. Vietnamese Journal of Radiology and Nuclear Medicine, 34, 10-18. https://doi.org/10.55046/vjrnm.34.573.2019

CT findings for diagnosis of bowel ischemia and necrosis in closed-loop small-bowel obstruction

Vu Thi Thu Huong1, Vo Tan Duc2,
1 Department of Diagnostic Imaging, University of Medicine and Pharmacy Ho Chi Minh City
2 Department of Diagnostic Imaging, University of Medicine and Pharmacy, Ho Chi Minh City

Main Article Content

Abstract

SUMMARY


Purpose: The aim of this study was to investigate the imaging features of contrast-enhanced CT (CECT) to diagnosis for bowel ischemiaand necrosis in closed-loop small-bowel obstruction (CL-SBO), and to predict the need for intestinal resection or preservation.
Materials and Methods: Thirty-three patients with CL-SBO confirmed by laparotomy. Based on the surgical findings, these patients were classified into three groups: necrosis group (n = 9), ischemia without necrosis group (n = 12), and no-ischemia group (n = 12). Two blinded radiologists retrospectively reviewed CECT including multiplanar reconstruction images and evaluated 11 CT findings. The sensitivity and specificity of each finding were compared among the three groups, and logistic regression analysis was performed.
Results:Reduced bowel- wall enhancement, reduced enhancement of the mesenteric veins showed high specificities of 92%, 96% and sensitivities of 62% and 78%, respectively, for the prediction of bowel necrosis in CL-SBO. The target sign in the ischemia group were 83% and 76%, respectively, for sensitivities and specificities, compared with 22% and 46% of the necrosis
group. We have included the data in a univariate and multivariate logistic regression analysis, but there is no correlation between imaging features and surgical findings. This can be explained by the interval between CT and laparotomy has altered bowel conditions.
Conclusions: In our prospective patients, reduced enhancements of bowel wall and mesenteric veins were good indicators of bowel necrosis. On the contrary, target sign was a predictor of a viable bowel.

Article Details

Keywords

intestinal obstruction, closed loop, ischemia, necrosis, computed tomography

References

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