Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept.
Journal
Gastroenterology research and practice
ISSN: 1687-6121
Titre abrégé: Gastroenterol Res Pract
Pays: Egypt
ID NLM: 101475557
Informations de publication
Date de publication:
2019
2019
Historique:
received:
31
12
2018
revised:
29
06
2019
accepted:
07
08
2019
entrez:
5
10
2019
pubmed:
5
10
2019
medline:
5
10
2019
Statut:
epublish
Résumé
To compare sensitivity of unenhanced computed tomography (CT) and contrast-enhanced CT for the identification of the etiology of bowel obstruction. We retrospectively evaluated abdominal CT scans of patients operated for bowel obstruction from March 2013 to October 2017. Two radiologists evaluated CT scans before and after contrast agent in two reading sessions. Then, we calculated sensitivity of CT in the diagnosis of bowel obstruction and determined in which cases the etiology of bowel obstruction was detected on both unenhanced and enhanced CT or on enhanced CT only. The reference standard was defined as the final diagnosis obtained after surgery. Eighteen patients (mean age 72 ± 15 years, age range 37-88 years) were included in the study. Sensitivity of unenhanced CT and enhanced CT was not significantly different in either small bowel obstruction (64%, 7/11 patients vs. 73%, 8/11 patients; In the diagnosis of small bowel obstruction due to adhesions with normal bowel wall thickening and when a neoplasm is identified as the etiology of large bowel obstruction on unenhanced CT, an intravenous contrast agent may be avoided for the identification of the etiology. In remaining cases, contrast agent is still recommended.
Sections du résumé
BACKGROUND
BACKGROUND
To compare sensitivity of unenhanced computed tomography (CT) and contrast-enhanced CT for the identification of the etiology of bowel obstruction.
MATERIALS AND METHODS
METHODS
We retrospectively evaluated abdominal CT scans of patients operated for bowel obstruction from March 2013 to October 2017. Two radiologists evaluated CT scans before and after contrast agent in two reading sessions. Then, we calculated sensitivity of CT in the diagnosis of bowel obstruction and determined in which cases the etiology of bowel obstruction was detected on both unenhanced and enhanced CT or on enhanced CT only. The reference standard was defined as the final diagnosis obtained after surgery.
RESULTS
RESULTS
Eighteen patients (mean age 72 ± 15 years, age range 37-88 years) were included in the study. Sensitivity of unenhanced CT and enhanced CT was not significantly different in either small bowel obstruction (64%, 7/11 patients vs. 73%, 8/11 patients;
CONCLUSION
CONCLUSIONS
In the diagnosis of small bowel obstruction due to adhesions with normal bowel wall thickening and when a neoplasm is identified as the etiology of large bowel obstruction on unenhanced CT, an intravenous contrast agent may be avoided for the identification of the etiology. In remaining cases, contrast agent is still recommended.
Identifiants
pubmed: 31582969
doi: 10.1155/2019/2350948
pmc: PMC6748177
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2350948Informations de copyright
Copyright © 2019 Federica Vernuccio et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest.
Références
Eur J Radiol. 2009 Jul;71(1):135-40
pubmed: 18534800
Radiology. 2009 Oct;253(1):31-46
pubmed: 19789254
Radiographics. 2001 Mar-Apr;21(2):341-55
pubmed: 11259698
Eur J Radiol. 2004 Apr;50(1):15-22
pubmed: 15093231
Semin Ultrasound CT MR. 2016 Feb;37(1):16-22
pubmed: 26827734
Diagn Interv Imaging. 2019 Jun 14;:null
pubmed: 31208938
Eur Radiol. 2018 Jul;28(7):2845-2855
pubmed: 29426991
Eur Radiol. 2017 Feb;27(2):868-877
pubmed: 27271919
BMJ. 2009 Jun 26;338:b2431
pubmed: 19561056
Semin Ultrasound CT MR. 2016 Feb;37(1):23-30
pubmed: 26827735
Biomed Res Int. 2014;2014:741018
pubmed: 24895606
Am Surg. 2018 Jun 1;84(6):1015-1021
pubmed: 29981641
J Clin Endocrinol Metab. 2015 Feb;100(2):376-83
pubmed: 25375985
Radiology. 2015 Jun;275(3):651-63
pubmed: 25997131
J Am Coll Radiol. 2018 Oct;15(10):e29
pubmed: 30037706
Arch Surg. 2012 Feb;147(2):175-80
pubmed: 22351915
J Clin Epidemiol. 2008 Apr;61(4):344-9
pubmed: 18313558
AJR Am J Roentgenol. 1996 Dec;167(6):1451-5
pubmed: 8956576
Eur J Radiol. 2013 Sep;82(9):e387-99
pubmed: 23711425
Acad Radiol. 2017 Jul;24(7):840-845
pubmed: 28237189
Br J Surg. 1989 Nov;76(11):1121-5
pubmed: 2597964