Small-bowel obstruction: coronal reformations from isotropic voxels at 16-section multi-detector row CT.
OBJECTIVE
To retrospectively assess the added value of coronal reformations of the abdomen and pelvis from isotropic voxels by using 16-section multi-detector row computed tomography (CT) for the diagnosis of small-bowel obstruction (SBO).


METHODS
This HIPAA-compliant study was approved by the institutional review board of this medical center with a waiver of informed consent. One hundred consecutive patients (40 men and 60 women; mean age, 55 years) suspected of having SBO and abdominal pain underwent 16-section multi-detector row CT with coronal reformations. Twenty-nine patients had a final diagnosis of SBO, and 71 patients did not. Three independent readers blinded to the diagnosis interpreted the CT scout scan, then transverse scans alone, and then transverse plus coronal scans for the presence of SBO and abnormal wall enhancement. Confidence was scored with a 1-5 scale (1 = absent, 5 = present).


RESULTS
Mean sensitivity and specificity of CT scout alone, transverse CT alone, and transverse plus coronal CT for the diagnosis of SBO were 88% and 86%, 87% and 87%, and 87% and 90%, respectively (not significant). In patients without SBO, transverse plus coronal CT enhanced confidence in the exclusion of SBO (P = .01). In patients with SBO, transverse plus coronal CT enhanced confidence in the diagnosis of SBO and identification of abnormal wall enhancement (P = .01).


CONCLUSIONS
Transverse 16-section multi-detector row CT data sets are an excellent test for the diagnosis of SBO, while the addition of coronal reformations obtained from these isotropic data sets adds confidence to the diagnosis and exclusion of SBO.
Jaffe
Tracy A
TA
Department of Radiology, Duke University Medical Center, Erwin Rd, Box 3808, Durham, NC 27710, USA. jaffe002@mc.duke.edu
Martin
Lucie C
LC
Thomas
John
J
Adamson
Andrew R
AR
DeLong
David M
DM
Paulson
Erik K
EK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging*; D007421:Intestine, Small; D007479:Iopamidol / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007479:Iopamidol