Increased Attenuation of Intestinal Contents at CT Indicates Bowel Necrosis in Closed-Loop Small Bowel Obstruction

医学 坏死 优势比 回顾性队列研究 肠梗阻 围手术期 粘附 胃肠病学 内科学 放射科 有机化学 化学
作者
Bingqi Li,Wei-Jun Qi,Yuan Meng,Hangyan Wang,Ming Chen,Zixiu Song,Qi Li,Lei Li,Bin Jiang,Zhaolai Ma,Dianrong Xiu,Chun-Hui Yuan
出处
期刊:Radiology [Radiological Society of North America]
卷期号:310 (2) 被引量:11
标识
DOI:10.1148/radiol.231710
摘要

Background Preoperative recognition of irreversible bowel necrosis is important, as it provides valuable guidance for surgical strategy selection but also may inform perioperative risk assessment and communication. Few studies have focused on the association between CT signs and bowel necrosis. Purpose To assess the diagnostic accuracy of CT signs to predict bowel necrosis in patients with closed-loop small bowel obstruction (CL-SBO). Materials and Methods This retrospective single-center study included patients who were surgically confirmed to have CL-SBO caused by adhesion or internal hernia between January 2016 and May 2022. Necrosis was determined based on surgical exploration and postoperative pathologic examination. Two radiologists independently reviewed CT signs by both subjective visual assessment and objective measurement. Disagreements were resolved in consensus with a third gastrointestinal radiologist. Univariable and multivariable analyses were used to assess the association between CT signs and bowel necrosis, and Cohen κ was used to assess interobserver agreement. Sensitivity and specificity were calculated for each CT sign. Results This study included 145 patients: 61 (42.1%) in the necrotic group (median age, 62 years [IQR, 51–71.5 years]; 37 [60.7%] women) and 84 (57.9%) in the nonnecrotic group (median age, 61.5 years [IQR, 51–68.8 years]; 51 [60.7%] women). Univariable analysis and multivariable analysis showed that increased attenuation of intestinal contents and increased attenuation of intestinal wall were independent predictors for bowel necrosis (odds ratio = 45.3 and 15.1; P = .001 and P < .001, respectively). Increased attenuation of intestinal contents and increased attenuation of intestinal wall had similar sensitivity (64% and 67%, respectively) and specificity (99% and 92%, respectively) for predicting bowel necrosis. However, interobserver agreement was better for assessing the contents than the wall (κ = 0.84 and 0.59, respectively). Conclusion Increased attenuation of intestinal contents was a highly specific CT sign with good reproducibility to predict bowel necrosis in CL-SBO. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Taourel and Zins in this issue.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
王洋完成签到,获得积分10
1秒前
lw777完成签到,获得积分20
1秒前
慢慢完成签到,获得积分10
1秒前
2秒前
靖123456发布了新的文献求助10
2秒前
拓跋箴完成签到,获得积分10
2秒前
彭于晏应助zy采纳,获得10
3秒前
精明玲完成签到 ,获得积分10
4秒前
4秒前
乐乐完成签到,获得积分10
5秒前
VirSnorlax完成签到,获得积分10
5秒前
SciGPT应助LL采纳,获得10
5秒前
妖孽宇发布了新的文献求助10
6秒前
aa完成签到,获得积分20
6秒前
aaaa完成签到,获得积分10
6秒前
马香芦完成签到,获得积分10
7秒前
西红柿完成签到,获得积分10
8秒前
9秒前
懵懂的冬灵完成签到,获得积分10
9秒前
碧蓝可仁完成签到 ,获得积分10
10秒前
王拉拉完成签到 ,获得积分10
10秒前
西西完成签到,获得积分10
10秒前
深情安青应助mkmimii采纳,获得10
11秒前
上官若男应助小王采纳,获得10
11秒前
bkagyin应助旦皋采纳,获得10
11秒前
Orange应助欣欣采纳,获得10
12秒前
玄学大哥完成签到,获得积分10
12秒前
12秒前
12秒前
kk完成签到,获得积分10
12秒前
ww007完成签到,获得积分10
14秒前
科研通AI5应助hahaha123213123采纳,获得10
14秒前
misstwo完成签到,获得积分10
15秒前
研友_ZzrwqZ发布了新的文献求助10
15秒前
JY'完成签到,获得积分10
16秒前
一只小鲨鱼完成签到,获得积分10
17秒前
漂亮的哈密瓜完成签到,获得积分10
17秒前
量子星尘发布了新的文献求助10
17秒前
18秒前
LL发布了新的文献求助10
18秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
Research on Disturbance Rejection Control Algorithm for Aerial Operation Robots 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038388
求助须知:如何正确求助?哪些是违规求助? 3576106
关于积分的说明 11374447
捐赠科研通 3305798
什么是DOI,文献DOI怎么找? 1819322
邀请新用户注册赠送积分活动 892672
科研通“疑难数据库(出版商)”最低求助积分说明 815029