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Value of multidetector CT in decision making regarding surgery in patients with small-bowel obstruction due to adhesion

Title
Value of multidetector CT in decision making regarding surgery in patients with small-bowel obstruction due to adhesion
Authors
Hwang J.-Y.Lee J.K.Lee J.E.Baek S.Y.
Ewha Authors
백승연이정경황지영이지은
SCOPUS Author ID
백승연scopus; 이정경scopus; 황지영scopus; 이지은scopus
Issue Date
2009
Journal Title
European Radiology
ISSN
0938-7994JCR Link
Citation
vol. 19, no. 10, pp. 2425 - 2431
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
The aim of this study was to evaluate the value of use of multidetector CT (MDCT) to predict the need for subsequent surgery in patients with small-bowel obstruction (SBO) due to adhesion. During a 3-year period, 128 patients with an SBO due to adhesion were enrolled in this prospective study. Initially, all patients were treated conservatively. Surgery was performed in patients who developed signs of strangulation or did not improve, despite a conservative treatment for at least 5 days. Of the 128 patients, 37 patients eventually underwent surgery. Two radiologists interpreted MDCT findings regarded as predictive indicators for subsequent surgery in consensus. The findings included degree of SBO, presence of transition zone, and an abnormal vascular course. These findings were statistically compared between the group operated on and the group not operated on. A higher degree of SBO, an abnormal vascular course, and the presence of transition zone were more frequently seen in the group of patients operated on (p<0.001). Sensitivities, specificities, positive and negative predictive values, and risks for the use of MDCT to predict the need for surgery were 100%, 46.1%, 43%, 100%, and 1.9 (1.5≤95% confidence interval (CI)≤2.2) for a high-grade obstruction; 100%, 23%, 34.5%, 100%, and 1.3 (1.2≤95% Cl≤1.5) for the presence of a transition zone; and 70.2%, 90.1%, 74.2%, 88.1%, and 7.1 (3.7≤95% CI≤13.7) for the presence of an abnormal course of the mesenteric vessels, respectively. The presence of a high degree of SBO and an abnormal vascular course around transition zone are useful indicators on MDCT to predict the need for surgery in patients with an SBO due to adhesion. © European Society of Radiology 2009.
DOI
10.1007/s00330-009-1424-4
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의학전문대학원 > 의학과 > Journal papers
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