To Explore The Values Of 64-slice Computed Tomography In The Diagnosis Of Intestinal Obstruction

Objective: Evaluate the value of the new technology to intestinal obstruction, which is the combination of 64-slice CT with three-dimensional reconstruction(3D reconstruction).Methods: Basing on experience of Changsha Central Hospital, 442 cases of intestinal obstruction investigated with both 64-slice CT and simultaneous colonoscopy or surgery were evaluated considering between August 2012 and October 2014. The patients(283 males, 159 females), aged 3 to 99–year–old with an average age of 63.7 years, were enrolled in this study. Our study was divided into two sections. The first section compares the diagnostic values between 64-slice CT scan, 64-slice CT enhanced scan and 64-slice CT scan combined with 3D reconstruction for the patients of intestinal obstruction; The two radiologists were blind to respectively observe several parameters including with or without intestinal obstruction, the degree, location, etiology, closed-loop obstruction and strangulation. In the second section, the values of 64-slice CT scan combined with 3D reconstruction and colonoscopy to determine the location and etiology of intestinal obstruction were considered. Statistical Methods: The SPSS for Windows 18.0 software package was used for statistical analysis. Data are expressed as rates or the constituent ratios. The χ2 test was used to evaluate the statistical differences in 64-slice CT scan, CT enhanced scan, CT scan combined with 3D reconstruction and colonoscopy. A p value of less than 0.05 was considered to represent a significant difference.Results: 1.The diagnostic ratios for the presence of intestinal obstruction based on 64-slice CT scan, CT enhanced scan and CT scan combined with 3D reconstruction are all 100%. For the degree of intestinal obstruction, there could be up to 96%, while CT scan combined with 3D reconstruction is highest(99.1%). There are no significant differences in with or without intestinal obstruction and the degree of obstruction among the three methods(P>0.05). The ratios of the location and etiology of intestinal obstruction could be more than 87% and 77% respectively, while the ratios of CT scan combined with 3D reconstruction is higher than the other two methods, which were up to 97.7% and 95.8%, and there was significant difference(P<0.05). Meanwhile, the diagnostic ratios for closed-loop obstruction and strangulation based on CT combined with 3D reconstruction is significantly higher than the CT scan(50.0%, 33.3%), and contrast-enhanced CT(88.9%, 90.9%), with 94.7% and 96.3% respectively. Significant differences could be found in closed-loop obstruction and strangulation among 64-slice CT scan, contrast-enhanced CT and CT scan combined with 3D reconstruction(P<0.05). 2. Comparing with the diagnostic ratios of location and etiology in the patients with colorectal incomplete obstruction between 64-slice CT scan combined with 3D reconstruction and colonoscopy, which shows colonoscopy(96.6%, 96.7%) was higher than CT scan combined with 3D reconstruction(89.7%, 86.2%), while no significant differences could be found(P>0.05).Conclusion: 1. 64-slice CT scan combined with 3D reconstruction better than 64-slice CT scan and contrast-enhanced CT in determining location, etiology of obstruction, closed-loop obstruction and strangulation. 2. 64-slice CT scan combined with 3D reconstruction is similar to colonoscopy for diagnosing the location and etiology of colorectal obstruction. 3. The 64-slice CT scan with 3D reconstruction could be considered as one of the best methods to diagnosis intestinal obstruction.