Adult intestinal intussusception: can abdominal MDCT distinguish an intussusception caused by a lead point?
BACKGROUND
Aim of our study was to assess the ability of computed tomography to distinguish between an intussusception with a lead-point from one without it.


METHODS
Approval was granted by the Institutional Review Board. Ninety-three consecutive patients diagnosed with an intussusception on abdominal CT were classified with or without lead-point by surgery, clinical or radiological follow-up. Two radiologists blinded to the classification independently reviewed the CT images for predefined predictive variables.


RESULTS
Non-lead-point intussusception was shorter in length (mean 4.9 vs. 11.1 cm for Reader 1 (R1); mean 4.0 vs. 8.9 cm for Reader 2 (R2), respectively, P < 0.001), smaller in axial diameter (mean 3.0 vs. 4.8 cm for R1; mean 2.8 vs. 4.4 cm for R2, P < 0.001, respectively), less likely associated with obstruction (P = 0.002 R1; P = 0.039 R2) and infiltration (P < 0.001 for R1, P = 0.003 R2) than lead-point intussusception.


CONCLUSIONS
Abdominal CT is helpful in distinguishing between an intussusception with a lead-point from one without a lead-point. Length, axial diameter, and their product, as well as obstruction and infiltration, all suggest the presence of a lead-point. Analysis of CT findings can reduce unnecessary imaging follow-up or operation.
Tresoldi
Silvia
S
Department of Diagnostic and Interventional Radiology, San Paolo Hospital, University of Milan, Via A. Di Rudinì 8, Milan, 20142, Italy.
Kim
Young H
YH
Blake
Michael A
MA
Harisinghani
Mukesh G
MG
Hahn
Peter F
PF
Baker
Stephen P
SP
Mueller
Peter R
PR
Kandarpa
Krishna
K
D000328:Adult; D003287:Contrast Media; D003937:Diagnosis, Differential; D003974:Diatrizoate Meglumine; D005260:Female; D006801:Humans; D007443:Intussusception / Q000000981:diagnostic imaging* / Q000601:surgery; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D003974:Diatrizoate Meglumine; D007479:Iopamidol