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Diagnostic performance of MDCT in identifying closed loop small bowel obstruction.

Publication ,  Journal Article
Makar, RA; Bashir, MR; Haystead, CM; Iseman, C; Mayes, N; Hebert, S; Allen, BC; Bhattacharya, SD; Choudhury, KR; Jaffe, TA
Published in: Abdom Radiol (NY)
July 2016

PURPOSE: To assess the diagnostic performance of MDCT in the diagnosis of closed loop small bowel obstruction. MATERIALS AND METHODS: One hundred fifty patients with CT reports including "small bowel obstruction (SBO)" between 1/30/2011 and 12/4/2012 were included (65 men, 85 women, mean age 63 years). CT examinations were independently and blindly reviewed by five radiologists to determine the presence of closed loop obstruction (CL-SBO) and to assess findings of bowel ischemia. Clinical records were reviewed to determine management and operative findings. Using operative findings as a gold standard, reader agreement for the diagnosis of and the CT findings associated with CLO was analyzed using Pearson's correlation (r). Positive predictive value (PPV) and negative predictive value for the diagnosis of CL-SBO and CT signs of bowel ischemia were analyzed. RESULTS: Eighty-eight of 150 patients underwent operative intervention for SBO and 24/88 were considered CL-SBO operatively. Average reader sensitivity and specificity for CL-SBO was 53 % (95 % CI 44-63 %) and 83 % (95 % CI 79-87 %). Reader agreement on CL-SBO was poor to moderate (K = 0.39-0.63). Reader agreement for CT signs of bowel ischemia resulting in a diagnosis of CL-SBO was weak (r = 0.19-0.32). CONCLUSION: The CT diagnosis of CL-SBO is complex and associated imaging findings have variable sensitivity for predicting a closed loop operative diagnosis. CT can be helpful in excluding a closed loop component in patients with SBO.

Duke Scholars

Published In

Abdom Radiol (NY)

DOI

EISSN

2366-0058

Publication Date

July 2016

Volume

41

Issue

7

Start / End Page

1253 / 1260

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Retrospective Studies
  • Predictive Value of Tests
  • Multidetector Computed Tomography
  • Middle Aged
  • Male
  • Iopamidol
  • Intestine, Small
  • Intestinal Obstruction
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Makar, R. A., Bashir, M. R., Haystead, C. M., Iseman, C., Mayes, N., Hebert, S., … Jaffe, T. A. (2016). Diagnostic performance of MDCT in identifying closed loop small bowel obstruction. Abdom Radiol (NY), 41(7), 1253–1260. https://doi.org/10.1007/s00261-016-0656-4
Makar, Ryan A., Mustafa R. Bashir, Clare M. Haystead, Christine Iseman, Nicholas Mayes, Stuart Hebert, Brian C. Allen, Syamal D. Bhattacharya, Kingshuk R. Choudhury, and Tracy A. Jaffe. “Diagnostic performance of MDCT in identifying closed loop small bowel obstruction.Abdom Radiol (NY) 41, no. 7 (July 2016): 1253–60. https://doi.org/10.1007/s00261-016-0656-4.
Makar RA, Bashir MR, Haystead CM, Iseman C, Mayes N, Hebert S, et al. Diagnostic performance of MDCT in identifying closed loop small bowel obstruction. Abdom Radiol (NY). 2016 Jul;41(7):1253–60.
Makar, Ryan A., et al. “Diagnostic performance of MDCT in identifying closed loop small bowel obstruction.Abdom Radiol (NY), vol. 41, no. 7, July 2016, pp. 1253–60. Pubmed, doi:10.1007/s00261-016-0656-4.
Makar RA, Bashir MR, Haystead CM, Iseman C, Mayes N, Hebert S, Allen BC, Bhattacharya SD, Choudhury KR, Jaffe TA. Diagnostic performance of MDCT in identifying closed loop small bowel obstruction. Abdom Radiol (NY). 2016 Jul;41(7):1253–1260.
Journal cover image

Published In

Abdom Radiol (NY)

DOI

EISSN

2366-0058

Publication Date

July 2016

Volume

41

Issue

7

Start / End Page

1253 / 1260

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Retrospective Studies
  • Predictive Value of Tests
  • Multidetector Computed Tomography
  • Middle Aged
  • Male
  • Iopamidol
  • Intestine, Small
  • Intestinal Obstruction
  • Humans