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Differentiation of simple and strangulated small-bowel obstructions: usefulness of known CT criteria.

机译：简单和绞窄的小肠梗阻的鉴别：已知CT标准的有用性。

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摘要

PURPOSE: To evaluate the usefulness of known computed tomographic (CT) criteria for the differentiation of simple and strangulated small-bowel obstructions. MATERIALS AND METHODS: CT scans of 84 patients with simple (n = 43) and strangulated (n = 41) small-bowel obstructions caused by adhesions, hernia, and volvulus were reviewed retrospectively. Diagnoses were made with surgery (n = 55) and during clinical follow-up (n = 29). CT criteria evaluated were configuration of obstructed bowel loop, target sign, bowel wall thickening and enhancement, changes in mesentery and mesenteric vasculature, and amount and attenuation of ascites. RESULTS: CT findings that enabled the detection of strangulated obstructions were poor or no enhancement of bowel wall (sensitivity, 34%; specificity, 100%) and a serrated beak (sensitivity, 32%; specificity, 100%). When these two findings were excluded from analysis, a large amount of ascites, an unusual course of mesenteric vasculature, and diffuse engorgement of mesenteric vasculature were shown to be useful CT findings for performing multivariate regression analysis. Application of these five CT findings enabled identification of 35 (85%) of 41 patients with strangulated obstructions. CONCLUSION: Detecting a combination of selected, known CT criteria increases the diagnostic accuracy of CT to enable differentiation of simple and strangulated small-bowel obstructions.
机译：目的：评估已知的计算机断层扫描（CT）标准对区分简单和绞窄小肠梗阻的有用性。材料与方法：回顾性分析了84例因粘连，疝气和肠扭转引起的单纯性小肠梗阻（n = 43）和绞窄（n = 41）的患者的CT扫描。通过手术（n = 55）和临床随访期间（n = 29）进行诊断。评估的CT标准是肠梗阻的形态，目标体征，肠壁增厚和增强，肠系膜和肠系膜脉管系统的变化以及腹水的数量和衰减。结果：能够发现绞窄性阻塞的CT表现差或肠壁无增强（敏感性34％;特异性100％）和锯齿状喙（敏感性32％;特异性100％）。当将这两个发现排除在分析之外时，大量腹水，肠系膜脉管系统异常进程和肠系膜脉管系统弥漫性充血被证明是进行多变量回归分析的有用CT表现。这五项CT检查结果的应用使41例梗阻性梗阻患者中的35例（85％）得以识别。结论：检测选定的已知CT标准的组合可提高CT的诊断准确性，从而能够区分简单和绞窄的小肠梗阻。

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