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

Verfasser / Beitragende:
[Kazuaki Nakashima, Hideki Ishimaru, Toshifumi Fujimoto, Takashi Mizowaki, Kazunori Mitarai, Kei Nakashima, Yohjiro Matsuoka, Masataka Uetani]
Ort, Verlag, Jahr:
2015
Enthalten in:
Abdominal Imaging, 40/5(2015-06-01), 1097-1103
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00261-014-0335-2  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00261-014-0335-2 
245 0 0 |a Diagnostic performance of CT findings for bowel ischemia and necrosis in closed-loop small-bowel obstruction  |h [Elektronische Daten]  |c [Kazuaki Nakashima, Hideki Ishimaru, Toshifumi Fujimoto, Takashi Mizowaki, Kazunori Mitarai, Kei Nakashima, Yohjiro Matsuoka, Masataka Uetani] 
520 3 |a Purpose: The aim of this study was to investigate the diagnostic performance of contrast-enhanced CT (CECT) findings for bowel ischemia and necrosis in closed-loop small-bowel obstruction (CL-SBO). Materials and Methods: Thirty-five patients with CL-SBO confirmed by laparotomy (n=34) or multiplanar reconstruction of thin slice CT images (n=1) were included. Based on the surgical and clinical findings, these patients were classified into three groups: necrosis group (n=16), ischemia without necrosis group (n=11), and no-ischemia group (n=8). Two blinded radiologists retrospectively reviewed CECT including multiplanar reconstruction images and evaluated 12 CT findings. The sensitivity and specificity of each finding were compared among the three groups, and logistic regression analysis was performed. Results: High attenuation of the bowel wall, intraperitoneal air, reduced enhancement of the mesenteric arteries, and small-bowel feces signs showed high specificities of 100%, 100%, 89%, and 89% but low sensitivities of 31%, 25%, 44%, and 31%, respectively, for the prediction of bowel necrosis in CL-SBO. According to multivariate logistic regression analysis, reduced bowel-wall enhancement, reduced enhancement of the mesenteric veins, and a lack of engorgement of the mesenteric veins were significant for predicting bowel ischemia or necrosis (P<0.05). Conclusions: Reduced enhancements of bowel wall and mesenteric veins were good indicators of bowel ischemia or necrosis. On the contrary, engorgement of the mesenteric veins was a predictor of a viable bowel. 
540 |a Springer Science+Business Media New York, 2014 
690 7 |a Small-bowel obstruction  |2 nationallicence 
690 7 |a Closed loop  |2 nationallicence 
690 7 |a Contrast-enhanced CT  |2 nationallicence 
690 7 |a Bowel ischemia  |2 nationallicence 
690 7 |a Mesenteric artery  |2 nationallicence 
690 7 |a Mesenteric vein  |2 nationallicence 
700 1 |a Nakashima  |D Kazuaki  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
700 1 |a Ishimaru  |D Hideki  |u Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan  |4 aut 
700 1 |a Fujimoto  |D Toshifumi  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
700 1 |a Mizowaki  |D Takashi  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
700 1 |a Mitarai  |D Kazunori  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
700 1 |a Nakashima  |D Kei  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
700 1 |a Matsuoka  |D Yohjiro  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
700 1 |a Uetani  |D Masataka  |u Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan  |4 aut 
773 0 |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/5(2015-06-01), 1097-1103  |x 0942-8925  |q 40:5<1097  |1 2015  |2 40  |o 261 
856 4 0 |u https://doi.org/10.1007/s00261-014-0335-2  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
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950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00261-014-0335-2  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Nakashima  |D Kazuaki  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ishimaru  |D Hideki  |u Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Fujimoto  |D Toshifumi  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Mizowaki  |D Takashi  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Mitarai  |D Kazunori  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Nakashima  |D Kei  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Matsuoka  |D Yohjiro  |u Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Uetani  |D Masataka  |u Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/5(2015-06-01), 1097-1103  |x 0942-8925  |q 40:5<1097  |1 2015  |2 40  |o 261