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Preoperative intestine-to-liver CT ratio: useful predictor of resection in strangulated obstruction

  • 0Department of Surgery, National Defense Medical College, 3-2, Namiki, Saitama, Tokorozawa, 359-8513, Japan.
Emergency Radiology +

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July 16, 2025

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July 16, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

A low intestinal-to-liver CT attenuation ratio (<0.40) effectively predicts the need for intestinal resection in strangulated bowel obstruction (SBO) patients. This imaging marker aids in prompt diagnosis and surgical planning for SBO.

Area Of Science

  • Radiology
  • Gastroenterology
  • Surgical Oncology

Background

  • Prompt diagnosis of strangulated bowel obstruction (SBO) is crucial to prevent severe complications.
  • Delayed recognition of SBO can lead to irreversible intestinal ischemia and necessitate resection.

Purpose Of The Study

  • To evaluate the efficacy of the intestinal-to-liver CT attenuation value ratio in predicting the need for intestinal resection in SBO patients.
  • To assess if this ratio can serve as an imaging biomarker for surgical intervention in SBO.

Main Methods

  • Retrospective analysis of 52 patients with suspected SBO undergoing emergency surgery.
  • Comparison of preoperative clinical and imaging findings between patients requiring intestinal resection (n=35) and those who did not (n=17).
  • Calculation and analysis of the intestinal-to-liver CT attenuation ratio.

Main Results

  • The resection group exhibited a significantly lower intestinal-to-liver CT attenuation ratio (p < 0.0001).
  • This ratio, along with time to surgery, independently predicted the need for resection (OR 15.50 for ratio).
  • A ratio < 0.40 was associated with a 92% resection rate and demonstrated high diagnostic performance (AUROC 0.886).

Conclusions

  • An intestinal-to-liver CT attenuation ratio below 0.40 is a strong predictor of intestinal ischemia requiring resection in SBO.
  • This imaging metric can aid clinicians in identifying SBO patients who will likely benefit from surgical intervention.
  • Utilizing this CT-based ratio can improve surgical decision-making and patient outcomes in SBO management.

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