Abstract
Feasibility of diagnosing small bowel obstruction on multidetector-row computed tomography (MDCT) using coronal reformations alone is evaluated. Three radiologists with subspecialty training in abdominal imaging reviewed abdominopelvic CT of 67 patients in consensus. Thirty-four patients had surgically proven small bowel obstruction. The remaining 33 patients had CT for other reasons and had no intestinal obstruction. The images were displayed in either axial or coronal planes and were reviewed on separate days . Each CT was evaluated for the presence of small bowel obstruction and its etiology when applicable. Thirty-three (100%) of 33 patients were correctly diagnosed not to have intestinal obstruction on coronal images. Thirty-four (100%) of 34 patients were correctly diagnosed to have small bowel obstruction on both forms of image display. There were five patients where the final surgical diagnosis for the etiology of small bowel obstruction did not agree with the interpretation of either the coronal or axial images; however, in all five patients, the interpretations of axial and coronal images were similar. In only one patient, the etiology of small bowel obstruction based on the coronal images did not agree with that of axial images and the surgical result; however, the site of small bowel obstruction was correctly diagnosed. There were approximately 20% fewer images in the coronal reformation data set, and the radiologists found review of these images to be easier for localizing the zone of transition in small bowel obstruction. Very high diagnostic accuracy can be achieved based on coronal reformations alone, and this form of image display may potentially be substituted for the conventional axial images. Since there are fewer images to review when the studies are displayed in coronal plane, this may positively impact radiologist workflow.
Similar content being viewed by others
References
Suh RS, Maglinte DDT, Lavonas EJ et al (1995) Emergency abdominal radiography: discrepancies of preliminary and final interpretation and management relevance. Emerg Radiol 2:1–4
McFadden DW, Zinner MJ (1994) Manifestations of gastrointestinal disease. In: Schwartz SI, Shires GT, Spencer FC (eds) Principles of surgery. McGraw-Hill, New York, pp 1015–1042
Megibow AJ, Balthazar EJ, Cho KC, Medwid SW, Birnbaum BA, Noz ME (1991) Bowel obstruction: evaluation with CT. Radiology 180:313–318
Fukuya T, Hawes DR, Lu CC, Chang PJ, Barloon TJ (1992) CT diagnosis of small-bowel obstruction: efficacy in 60 patients. AJR Am J Roentgenol 158:765–769
Furukawa A, Yamasaki M, Furuichi K et al (2001) Helical CT in the diagnosis of small bowel obstruction. Radiographics 21:341–355
Maglinte DT, Reyes BL, Harmon BH et al (1996) Reliability and role of plain film radiography and CT in the diagnosis of small-bowel obstruction. AJR Am J Roentgenol 167:1451–1455
Hu H, He HD, Foley WD, Fox SH (2000) Four multidetector-row helical CT: image quality and volume coverage speed. Radiology 215:55–62
Flohr TG, Schaller S, Stierstorfer K, Bruder H, Ohnesorge BM, Schoepf UJ (2005) Multi-detector row CT systems and image-reconstruction techniques. Radiology 235:756–773
Rydberg J, Buckwalter KA, Caldemeyer KS et al (2000) Multisection CT: scanning techniques and clinical applications. Radiographics 20:1787–1806
Caoili EM, Paulson EK (2000) CT of small-bowel obstruction: another perspective using multiplanar reformations. AJR Am J Roentgenol 174:993–998
Donckier V, Closset J, Van Gransbeke D et al (1998) Contribution of computer tomography to decision making in the management of adhesive small bowel obstruction. Br J Surg 85:1071–1074
Paulson EK, Jaffe TA, Thomas J, Harris JP, Nelson RC (2004) MDCT of patients with acute abdominal pain: a new perspective using coronal reformations from submillimeter isotropic voxels. AJR Am J Roentgenol 183:899–906
Rubin GD (2000) Data explosion: the challenge of multidetector-row CT. Eur J Radiol 36:74–80
Sherbondy AJ, Holmlund D, Rubin GD, Schraedley PK, Winograd T, Napel S (2005) Alternative input devices for efficient navigation of large CT angiography data sets. Radiology 234:391–398
Schmidt S, Chevallier P, Chalaron M et al (2005) Multidetector CT enteroclysis: comparison of the reading performance for axial and coronal views. Eur Radiol 15:238–246
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yaghmai, V., Nikolaidis, P., Hammond, N.A. et al. Multidetector-row computed tomography diagnosis of small bowel obstruction: can coronal reformations replace axial images?. Emerg Radiol 13, 69–72 (2006). https://doi.org/10.1007/s10140-006-0513-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10140-006-0513-9