Computed tomography of bowel obstructions: The contribution of multiplanar reformations in comparison with axial slices alone in determining the transition zone

Abstract

Several studies have demonstrated that determining the transition zone could facilitate

the diagnosis of bowel obstruction (BO) using multi-detector row computed

tomography (MDCT). We aimed to evaluate the contribution of multi-planar

reformations (MPR) in comparison with axial slices alone to determine the

transition zone. Sixteen-slice MDCT examinations of 66 consecutive patients

with mechanical BO were reviewed by an experienced abdominal radiologist

who had been blinded to the patients’ clinical diagnoses. The scans were first

reviewed using the axial slices alone and later were reviewed using MPR with

respect to the assigned four-point confidence scale in a random order. The diagnostic

accuracy and mean confidence score were evaluated for both reviewing

methods. The accuracy for determining the transition zone using axial slices

alone was 92% in patients with small bowel obstruction (SBO) and 93% in

those with large bowel obstruction (LBO). The levels of accuracy for MPR were

exactly the same with axial slices alone both for SBO and LBO. The mean

confidence score for the determination of the transition zone using axial slices

alone was 3.59 for SBO and 3.71 for MPR (P=0.057). After evaluating patients

with LBO, the mean confidence score using axial slices alone was 3.80, which

was identical to that of MPR. Like MPR, axial CT source slices can also provide

high levels of accuracy in the determination of the transition zone in patients

with BO. However, particularly in SBO, MPR will increase confidence in the

diagnosis.

Keywords

• Bowel obstruction,MDCT,Multi-planar reformations,Transition zone

References

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