Small bowel obstruction: the value of coronal reformatted images from 16-multidetector computed tomography--a clinicoradiological perspective.
OBJECTIVE
To assess performance of 16-multidetector computed tomography for small bowel obstruction with surgery as standard of reference. To assess the impact of coronal reformats on reader confidence, and to address management perspective and surgeon's assessment of coronal images.


METHODS
16-Multidetector computed tomography scans of 30 patients presenting with clinical features of small bowel obstruction were reviewed. Five-millimeter axial images and 2.5-mm coronal images were available for interpretation. All patients had subsequent surgery. Two blinded readers independently reviewed axial and then coronal and axial (combination) images for transition site, etiology, and complications. Reader confidence was scored on a 3-point scale. A single surgeon evaluated studies for adequacy of scans and usefulness of coronal images.


RESULTS
Results showed that the recorded accuracies were slightly higher for etiology, transition site, and complications using the combination data set; this reached statistical significance for etiology only (P = 0.08). There was no significant increase in scan evaluation time with addition of coronal images. Surgeon considered the coronal images more informative as compared with the axial images in 76.6% of cases.


CONCLUSIONS
Coronal images generated at the scanner console are complementary to axials and improve reader confidence. Surgeons find coronal images more helpful than axial images for management.
Shah
Zarine K
ZK
Departments of Abdominal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Uppot
Raul N
RN
Wargo
Jennifer A
JA
Hahn
Peter F
PF
Sahani
Dushyant V
DV
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003287:Contrast Media / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000601:surgery; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000601:surgery; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D001466:Barium Sulfate; D007472:Iohexol