Preoperative evaluation by magnetic resonance imaging in patients with bowel obstruction.
BACKGROUND
Bowel obstruction is a problematic condition because the main clinical issue is to determine whether emergency laparotomy or observation with a long tube is required. The recent development of imaging diagnostic modalities such as magnetic resonance imaging (MRI) is thought to be promising to support therapeutic decisions in patients with bowel obstruction.


METHODS
Twenty-seven patients with bowel obstruction who underwent laparotomy were evaluated by plain x-ray film, computed tomography (CT) scan, and MRI preoperatively with regard to the presence or absence of bowel obstruction, and the site and cause of bowel obstruction. Diagnostic accuracies were compared among these radiological modalities.


RESULTS
The presence of bowel obstruction was detected in 22 (81.5%) of 27 patients by plain abdominal x-ray film, in 24 (92.3%) of 26 patients by CT scan, and in 25 (92.6%) of 27 patients by MRI. The sites of obstruction were consistent with surgical findings in 25 (92.6%) of 27 patients by MRI, and in 15 (57.7%) of 26 patients by CT scan. The causes of bowel obstruction were accurately diagnosed by MRI in 25 (92.6%) of 27 patients, and in 23 (88.5%) of 26 patients by CT scan.


CONCLUSIONS
MRI could identify the presence and the site and cause of bowel obstruction in most of the cases. MRI is assumed to be superior to CT scan in the preoperative diagnosis of bowel obstruction.
Matsuoka
Hiroyoshi
H
First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan. Hiroelvis@aol.com
Takahara
Taro
T
Masaki
Tadahiko
T
Sugiyama
Masanori
M
Hachiya
Junichi
J
Atomi
Yutaka
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000473:pathology*; D007813:Laparotomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed