Low b-value diffusion-weighted imaging for diagnosing strangulated small bowel obstruction: a feasibility study.

Area of Science:

• Radiology
• Medical Imaging
• Gastroenterology

Background:

• Small bowel obstruction (SBO) is a common surgical emergency.
• Diagnosing strangulation in SBO is critical for timely intervention and improved outcomes.
• Current diagnostic methods for strangulated SBO have limitations.

Purpose of the Study:

• To evaluate the feasibility of low b-value diffusion-weighted imaging (DWI) for diagnosing strangulated SBO.
• To assess the diagnostic performance of DWI in differentiating strangulated from non-strangulated small bowel loops.

Main Methods:

• Diffusion-weighted imaging (DWI) was performed at low b-values (0 and 50 s/mm²) in volunteers and patients with SBO.
• Apparent diffusion coefficients (ADCs) and signal preservation ratios (SPRs) were measured.
• Quantitative analysis of low b-value DWI was used to diagnose strangulation in patients.

Main Results:

• Significant differences in ADCs and SPRs were observed between volunteers before and after butylscopolamine administration.
• Mean ADCs and SPRs varied significantly among strangulated loops, near the obstruction, and far from the obstruction in SBO patients.
• Receiver operating characteristic curve analysis demonstrated high accuracy (0.937-1.000) for diagnosing strangulation.

Conclusions:

• Low b-value DWI is a feasible and effective technique for distinguishing strangulated closed loops in SBO.
• This imaging modality shows significant promise for the accurate diagnosis of strangulated SBO.