title: Diagnostic performance of multi-slice CT angiography combined with enterography for small bowel obstruction and intestinal ischaemia.
abstract: BACKGROUND
  This study was performed to evaluate the diagnostic performance of multi-slice CT angiography combined with enterography in determining the cause and location of obstruction as well as intestinal ischaemia in patients with small bowel obstruction (SBO).
  
  
  METHODS
  This study retrospectively summarized the image data of 57 SBO patients who received both multi-slice CT angiography and enterography examination between December 2012 and May 2013. The CT diagnoses of SBO and intestinal ischaemia were correlated with the findings at surgery or digital subtraction angiography, which were set as standard references.
  
  
  RESULTS
  Multi-slice CT angiography and enterography indicated that the cause of SBO in three patients was misjudged, suggesting a diagnostic accuracy of 94.7%. In one patient the level of obstruction was incorrect, demonstrating a diagnostic accuracy of 98.2%. Based on the results of the receiver operating characteristic (ROC) curve analysis, the diagnostic criterion for ischaemic SBO was at least two of the four CT signs (circumferential bowel wall thickening, reduced enhancement of the intestinal wall, mesenteric oedema and mesenteric vascular engorgement). The criterion yielded a sensitivity of 94.4%, a specificity of 92.3%, a positive predicted value of 85.0% and a negative predicted value of 97.3%, and the area under curve (AUC) was 0.92 (95% CI, 0.85-0.99).
  
  
  CONCLUSIONS
  Multi-slice CT angiography and enterography have high diagnostic value in identifying the cause and site of SBO. In addition, the suggested diagnostic criterion using CT signs is helpful for diagnosing intestinal ischaemia in SBO patients.
authors.affiliation: Department of Radiology, The Second Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Bosheng
authors.initials: B
authors.lastname: He
authors.affiliation: Department of Pathophysiology, Nantong University Medical School, Nantong, China.
authors.forename: Jinhua
authors.initials: J
authors.lastname: Gu
authors.affiliation: Department of Radiology, The Second Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Xuesong
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of Gastroenterology, The Second Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Jinhe
authors.initials: J
authors.lastname: Fan
authors.affiliation: Department of Radiology, The Second Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Meihong
authors.initials: M
authors.lastname: Sheng
authors.affiliation: Department of Radiology, The Second Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Radiology, The Second Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Shenchu
authors.initials: S
authors.lastname: Gong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000072226:Computed Tomography Angiography; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging*; D007421:Intestine, Small / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: angiography; diagnosis; multi-slice CT; small bowel obstruction