Clinical Application Of MSCT In Diagnosis Of Intestinal Obstruction

OBJECTIVE:1.To discuss the CT manifestations of intestinal obstruction(IO),and evaluate the role of CT in the diagnosis and management of the patients suspected of IO.2. To investigate the role of various CT detection and reconstruction techniques in diagnosing IO.3.Establish specific imaging signs of different type IO, raise the rate of early correctly diagnosis of severity type ileus such as volvulus,entocele, intussusception.MATERIALS AND METHODS:Data of 419 cases were collected,of which,289 cases were clinically or roentgenologically suspected of IO and 130 cases were clinically suspected of other diseases but were finally diagnosed as IO by CT.Preparations before CT examination,CT detection techniques(including plain,contrast-enhanced CT,delayed and/or dynamic scanning and images post-processing techniques),CT manifestations and diagnostic results were analyzed retrospectively,and compared with the results of surgical findings or clinical follow-up.RESULTS:1.As to the presence diagnosis of IO,in all the patients,CT diagnosis was consistent with the final results,while X-ray plain film had an accuracy of only 60.46% (237/392).The causes of IO included adhesion 88.63%(117/132),neoplasm 98.2% (112/114),extemal or intemal hernia 93.47%(43/46),intussusception 97.38%(37/38), inflammatory disease(including 7 cases paralytic ileus,83.33%30/36),enterolith 88.46% (23/26),bowel torsion 90.91%(10/11),trauma 62.5%(5/8),ischemia 100%(6/6), congenital lesion(100%,2/2).Total sensitivity of etiology diagnosis with CT was 92.84% (384/419),with accuracy,false positive and false negative to be 91.65%(384/419), 0.95%(4/419)and 7.4%(31/419),respectively.Whereas,accuracy of etiological diagnosis before CT examination was only 15.27%(64/419).Of the 385 cases with mechanical intestinal obstruction,the accuracies,as to the position,degree,and presence of close-loop and strangulation,were 97.97%(289/295),100.00%(17/17)and 90.48%(40/42), respectively.2.Exacerbation or other severe complications caused by CT examination was not noted in our study.CONCLUSION:1.MSCT can correctly diagnose the presence of the ileus,as well as its causes and characteristics,such as position,degree of severity,existence of close-loop and strangulation.2.Proper classification and preparation before CT exam are the basis of correct diagnosis.3.CT plain scan,contrast-enhanced CT,delayed and/or dynamic scanning have different value of diagnosis,respectively.4.Post-processing techniques is the necessary supplement of the forementioned methods and steps,which can reveal the lesion directly and reduce misdiagnosis.5.MSCT has important value in diagnosing different type IO,especially those severity type such as volvulus,entocele,intussusception and so on.