caa a22 4500 605495238 CHVBK 20210128100530.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00261-014-0262-2 doi (NATIONALLICENCE)springer-10.1007/s00261-014-0262-2 Multi-detector CT of blunt mesenteric injuries: usefulness of imaging findings for predicting surgically significant bowel injuries [Elektronische Daten] [Scott Steenburg, Matthew Petersen, Changyu Shen, Hongbo Lin] Purpose: The objective of this study is to determine which imaging features of blunt mesenteric injuries best predict the presence of a bowel injury requiring surgical correction. Methods: The radiology archives at a Level 1 trauma center were searched over a 5-year period to identify patients with mesenteric injuries seen on admission 64 slice MDCT. Two emergency radiologists, blinded to clinical and surgical outcomes, retrospectively recorded mesenteric injury size, the presence/absence of active mesenteric bleeding, bowel wall thickening, adjacent interloop free fluid, extraluminal gas, mesenteric vessel termination, mesenteric vessel "beading”, focal bowel wall defect, and bowel wall perfusion abnormality. Based on all of the imaging findings, the radiologists were asked to determine if they thought the patient had a surgical bowel injury. Results: One hundred twenty-six patients with mesenteric injuries were identified. Eighteen patients underwent laparotomy confirming the presence of bowel injury in 15. The remaining patients were successfully managed non-operatively. There was no statistically significant difference in size of mesenteric injury for surgical vs. non-surgical bowel injuries. Active bleeding, adjacent interloop free fluid, and bowel wall perfusion defects were strong predictors of the presence of a surgically significant bowel injury (p<0.001, 0.002, and 0.020, respectively). The overall accuracy, sensitivity, specificity, PPV, and NPV of 64-MDCT were 73.8%, 80%, 73.0%, 28.6%, and 96.4%, respectively. Conclusions: Mesenteric active bleeding, adjacent interloop free fluid and bowel wall perfusion defects are associated with surgically significant bowel injuries. The diagnosis of surgical bowel injuries remains challenging despite 64-slice MDCT technology. Springer Science+Business Media New York, 2014 Multi-detector CT nationallicence Blunt trauma nationallicence Mesenteric injuries nationallicence Steenburg Scott Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indiana University Health Methodist Hospital, 1701 N. Senate Blvd, Room AG-176, 46202, Indianapolis, IN, USA aut Petersen Matthew Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indiana University Health Methodist Hospital, 1701 N. Senate Blvd, Room AG-176, 46202, Indianapolis, IN, USA aut Shen Changyu Department of Biostatistics, Indiana University School of Medicine, Richard M. Fairbanks School of Public Health, 410 W. Tenth Street, Suite 3000, 46202, Indianapolis, IN, USA aut Lin Hongbo Department of Biostatistics, Indiana University School of Medicine, Richard M. Fairbanks School of Public Health, 410 W. Tenth Street, Suite 3000, 46202, Indianapolis, IN, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/5(2015-06-01), 1026-1033 0942-8925 40:5<1026 2015 40 261 https://doi.org/10.1007/s00261-014-0262-2 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/s00261-014-0262-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Steenburg Scott Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indiana University Health Methodist Hospital, 1701 N. Senate Blvd, Room AG-176, 46202, Indianapolis, IN, USA aut NATIONALLICENCE 700 1- Petersen Matthew Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indiana University Health Methodist Hospital, 1701 N. Senate Blvd, Room AG-176, 46202, Indianapolis, IN, USA aut NATIONALLICENCE 700 1- Shen Changyu Department of Biostatistics, Indiana University School of Medicine, Richard M. Fairbanks School of Public Health, 410 W. Tenth Street, Suite 3000, 46202, Indianapolis, IN, USA aut NATIONALLICENCE 700 1- Lin Hongbo Department of Biostatistics, Indiana University School of Medicine, Richard M. Fairbanks School of Public Health, 410 W. Tenth Street, Suite 3000, 46202, Indianapolis, IN, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/5(2015-06-01), 1026-1033 0942-8925 40:5<1026 2015 40 261