title: The accuracy of multidetector computed tomography in the diagnosis of non-occlusive mesenteric ischaemia in patients after cardiovascular surgery.
abstract: OBJECTIVE
  To determine the accuracy of multidetector computed tomography (MDCT) in the diagnosis of nonocclusive mesenteric ischaemia (NOMI) among patients after cardiovascular surgery.
  
  
  METHODS
  A retrospective review of 38 patients in a cardiothoracic intensive care unit who underwent MDCT examination before laparotomy for suspected NOMI between January 2001 and December 2012.
  
  
  METHODS
  The MDCT studies were examined independently by three radiologists, who were asked to make a determination on the presence or absence of NOMI. The radiological diagnosis was compared against the surgical and/or histological outcome to determine the diagnostic accuracy of MDCT.
  
  
  RESULTS
  The sensitivity and specificity of MDCT in the diagnosis of NOMI were 96% and 33%-60%, respectively. The positive and negative likelihood ratios and diagnostic odds ratio were 1.43-2.39, 0.072-0.13 and 11-33.2, respectively. The inter-rater agreement was 68%, with a Fleiss κ of 0.43.
  
  
  CONCLUSIONS
  MDCT has high sensitivity but lacks specificity in the diagnosis of NOMI. Its main value is in selection of patients for non-operative management, at least in the short-to-medium term.
authors.affiliation: Department of Diagnostic Radiology, Auckland District Health Board, Auckland, New Zealand. DMilne@adhb.govt.nz.
authors.forename: Henry C K
authors.initials: HC
authors.lastname: Kwok
authors.affiliation: Department of Diagnostic Radiology, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Ilse
authors.initials: I
authors.lastname: Dirkzwager
authors.affiliation: Department of Diagnostic Radiology, Auckland District Health Board, Auckland, New Zealand.
authors.forename: David S
authors.initials: DS
authors.lastname: Duncan
authors.affiliation: Cardiovascular Intensive Care Unit, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Gillham
authors.affiliation: Department of Diagnostic Radiology, Auckland District Health Board, Auckland, New Zealand.
authors.forename: David G
authors.initials: DG
authors.lastname: Milne
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures; D001026:Coronary Artery Bypass; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000000981:diagnostic imaging*; D008297:Male; D008643:Mesentery / Q000098:blood supply* / Q000000981:diagnostic imaging; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013152:Splanchnic Circulation