Comparison among preoperative single-slice CT and multi-slice CT in simple, closed loop and strangulating bowel...

Area of Science:

• Radiology
• Abdominal Imaging
• Surgical Diagnostics

Background:

• Bowel obstruction and intestinal necrosis are critical conditions requiring accurate preoperative assessment.
• Timely surgical intervention is crucial to reduce mortality associated with delayed operations.

Purpose of the Study:

• To compare the diagnostic accuracy of preoperative single-slice CT (SSCT) and multislice-CT (MSCT) in evaluating patients with bowel obstruction and intestinal necrosis.
• To assess the ability of CT to identify obstruction characteristics and signs of ischemia or necrosis.

Main Methods:

• Retrospective analysis of 64 patients with clinical and plain film evidence of bowel obstruction.
• Interpretation of SSCT scans (30 patients) and MSCT scans (34 patients) by three independent radiologists.
• Evaluation of obstruction presence, site, type, cause, and specific signs of strangulation or necrosis, with results compared to surgical findings.

Main Results:

• Both SSCT and MSCT demonstrated good correlation with surgical findings for bowel obstruction.
• MSCT showed a statistically significant advantage over SSCT in detecting intestinal ischemia, edema, and mesenteric vessel changes (p<0.05).
• High overall sensitivity (86.1%) and specificity (89.3%) were reported for CT in diagnosing bowel obstruction.

Conclusions:

• CT imaging is vital for determining the need for emergency surgery in bowel obstruction, enabling appropriate surgical timing and planning.
• Multislice-CT (MSCT) offers superior performance compared to single-slice CT (SSCT) in identifying intestinal necrosis and related complications.
• Accurate preoperative CT assessment improves surgical outcomes by correctly identifying obstruction details and complications.