Small-bowel obstruction: coronal reformations from isotropic voxels at 16-section multi-detector row CT

Area of Science:

• Radiology
• Medical Imaging

Background:

• Small-bowel obstruction (SBO) is a common surgical emergency.
• Accurate and timely diagnosis of SBO is crucial for patient management.
• Multi-detector row computed tomography (CT) is a primary imaging modality for evaluating SBO.

Purpose of the Study:

• To evaluate the added diagnostic value of coronal reformations from isotropic voxels using 16-section multi-detector row CT.
• To assess the impact of coronal reformations on the diagnosis of small-bowel obstruction (SBO).

Main Methods:

• Retrospective analysis of 100 patients with suspected SBO undergoing 16-section MDCT with coronal reformations.
• Three blinded readers interpreted CT scout, transverse scans alone, and transverse plus coronal scans.
• Diagnostic confidence for SBO and abnormal wall enhancement was scored on a 1-5 scale.

Main Results:

• Sensitivity and specificity for SBO diagnosis were similar across CT scout, transverse alone, and transverse plus coronal CT (87-88% sensitivity, 86-90% specificity).
• Transverse plus coronal CT significantly increased reader confidence in excluding SBO in patients without obstruction (P = .01).
• Transverse plus coronal CT significantly increased reader confidence in diagnosing SBO and identifying abnormal wall enhancement in patients with obstruction (P = .01).

Conclusions:

• Transverse 16-section multi-detector row CT datasets are highly effective for diagnosing SBO.
• The addition of coronal reformations from isotropic datasets enhances diagnostic confidence for both the presence and absence of SBO.