caa a22 4500 605494959 CHVBK 20210128100529.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00261-014-0335-2 doi (NATIONALLICENCE)springer-10.1007/s00261-014-0335-2 Diagnostic performance of CT findings for bowel ischemia and necrosis in closed-loop small-bowel obstruction [Elektronische Daten] [Kazuaki Nakashima, Hideki Ishimaru, Toshifumi Fujimoto, Takashi Mizowaki, Kazunori Mitarai, Kei Nakashima, Yohjiro Matsuoka, Masataka Uetani] 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. Springer Science+Business Media New York, 2014 Small-bowel obstruction nationallicence Closed loop nationallicence Contrast-enhanced CT nationallicence Bowel ischemia nationallicence Mesenteric artery nationallicence Mesenteric vein nationallicence Nakashima Kazuaki Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut Ishimaru Hideki Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan aut Fujimoto Toshifumi Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut Mizowaki Takashi Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut Mitarai Kazunori Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut Nakashima Kei Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut Matsuoka Yohjiro Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut Uetani Masataka Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/5(2015-06-01), 1097-1103 0942-8925 40:5<1097 2015 40 261 https://doi.org/10.1007/s00261-014-0335-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0335-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nakashima Kazuaki Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut NATIONALLICENCE 700 1- Ishimaru Hideki Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Fujimoto Toshifumi Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut NATIONALLICENCE 700 1- Mizowaki Takashi Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut NATIONALLICENCE 700 1- Mitarai Kazunori Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut NATIONALLICENCE 700 1- Nakashima Kei Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut NATIONALLICENCE 700 1- Matsuoka Yohjiro Department of Radiology, National Nagasaki Medical Center, 2-1001-1 Kubara, 856-8562, Omura, Japan aut NATIONALLICENCE 700 1- Uetani Masataka Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/5(2015-06-01), 1097-1103 0942-8925 40:5<1097 2015 40 261