Prognostic value of MDCT in malignant large-bowel obstructions
G Angelelli1, M Moschetta, F Binetti
1Di.M.I.M.P. - Sezione di Diagnostica per Immagini, Policlinico Universitario, Piazza Giulio Cesare 11, 70124 Bari, Italy. g.angelelli@radiologia.uniba.it
La Radiologia Medica
|February 24, 2010
Summary
Multidetector-row computed tomography (MDCT) can identify malignant large-bowel obstructions. Specific MDCT findings, like pneumatosis intestinalis and ascending colon diameter, correlate with patient prognosis.
Area of Science:
- Radiology
- Gastroenterology
- Oncology
Background:
- Malignant large-bowel obstructions present a significant clinical challenge.
- Accurate preoperative assessment is crucial for patient management and prognosis.
Purpose of the Study:
- To correlate multidetector-row computed tomography (MDCT) findings with postoperative prognosis in patients with malignant large-bowel obstructions.
- To evaluate the utility of MDCT in predicting outcomes for these patients.
Main Methods:
- A retrospective analysis of 27 patients with malignant colonic obstruction who underwent MDCT.
- Assessment of obstruction site, colon-wall morphology, intestinal content, and ascending colon diameter.
- Correlation of imaging findings with postoperative mortality rates.
Main Results:
- MDCT accurately identified obstruction sites in all cases.
- Intestinal content (air/fluid) and pneumatosis intestinalis were associated with prognosis.
- Ascending colon diameter ≥10 cm and pneumatosis intestinalis indicated poor prognosis (7/7 and 7/9 deceased patients, respectively).
- Air or fluid-predominant content suggested better prognosis (3/3 and 7/11 living patients, respectively).
Conclusions:
- MDCT is effective in detecting and localizing malignant large-bowel obstructions.
- MDCT findings provide valuable prognostic information, aiding in preoperative patient assessment and management strategies.
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