MDCT of Small Bowel Obstruction: How Reliable Are Oblique Reformatted Images in Localizing Point of Transition?

Abstract

The goal of this study is to prospectively assess the additional value of oblique reformatted images for localizing POT, having surgery as a reference standard. Materials and Methods. 102 consecutive patients with suspected small bowel obstruction (SBO) underwent 64-slice multidetector row CT (MDCT) using surgical findings as reference standard. Two independent GI radiologists reviewed the CT scans to localize the exact POT by evaluating axial images (data set A) followed by axial, coronal, and oblique MPR images. CT findings were compared to surgical findings in terms of diagnostic performance. McNemar's test was used to detect any statistical difference in POT evaluation between datasets A and B. Kappa statistics were applied for measuring agreement between two readers. Results. There was a diagnostic improvement of 9.9% in the case of the less experienced radiologist in localizing POT by using oblique reformatted images. The more experienced radiologist showed diagnostic improvement by 12.9%.

Role of Multidetector Computed Tomography with Multiplanar and Curved Multiplanar Reformations in the Detection of Cause of Intestinal Obstruction: A Tertiary Care Experience

“…He reported that adhesions were seen in 36% of patients of small bowel obstruction found in nine out of 25 patients [12]. In a study by Memon W et al, out of 120 patients, 59 (57.8%) were found to have adhesions, with 19 patients having adhesions at multiple levels [6]. The results of our study are in concordance with the results of these studies.…”

“…It is of immense importance to promptly diagnose the cause of bowel obstruction to prevent severe complications such as ischemia and bowel necrosis [1,6]. The diagnosis of bowel obstruction is made on the basis of history, clinical examination, and radiological findings [7].…”

Optimized protocol of multiple post-processing techniques improves diagnostic accuracy of multidetector computed tomography in assessment of small bowel obstruction compared with conventional axial and coronal reformations

“…For evaluating whether SBO was present and obstruction severity, there were no differences among the three protocols with respect to diagnostic self-confidence, agreement, detection rate, and accuracy. These results are consistent with previous findings[5,6,13,14,19,20] and suggest that the conventional axial and coronal reformations may be sufficient to evaluate whether SBO is present and the obstruction severity without the need for additional post-processing techniques.…”

“…Our study is the first to integrate and optimize the MDCT multiple post-processing techniques to develop a more accurate post-processing protocol for SBO assessment. The protocols mainly used MPR and CPR to show the obstruction site and its connected proximal and distal bowel segments[13,14,17-20]. MIP and VR were mainly used to reveal local mesenteric changes and mesenteric vascular diseases, as well as the obstruction site.…”

Computed Tomography Image Segmentation of the Proximal Colon by U-Net for the Clinical Study of Somatostatin Combined with Intestinal Obstruction Catheter

“…Common factors include inflammation, sympathetic nerve inhibition, release of neurotransmitters, hormones, and the use of narcotic drugs, analgesic drugs, etc. [22][23][24]. Inflammation can cause intestinal edema and hyperemia in patients, leading to intestinal adhesions and formation of intestinal obstruction.…”