Spiral computed tomography imaging of bowel ischemia: a literature review

The aim of this study was to evaluate the reported diagnostic efficacy of multidetector-row computed tomography (MDCT) for bowel ischemia and to identify the radiological signs that permit diagnosis. Based on a review of the literature, spiral CT sensitivity and specificity data were compared, as was the impact of last-generation CT scanner technology on the diagnosis of bowel ischemia. The data source was the PubMed database, from which 106 articles published in English from January 1998 to January 2006 were selected: 18 studies met the inclusion criteria. MDCT was reported to be more sensitive than CT for diagnosing bowel ischemia. The most frequent signs of disease were bowel wall thickening, intramural pneumatosis, mesenteric or portal venous gas, and mesenteric arterial or venous thromboembolism. The results of the literature review suggest that MDCT has high sensitivity for detecting bowel ischemia. Moreover, the use of MDCT angiography to evaluate abdominal vessels offers a better definition of vascular mapping and of the complications of bowel disease.