Emanuele Grassedonio MD, Presenter: Nothing to Disclose

Roberta Cianci MD, Abstract Co-Author: Nothing to Disclose

Francesca Di Fabio MD, Abstract Co-Author: Nothing to Disclose

Antonella Filippone MD, Abstract Co-Author: Nothing to Disclose

To compare the diagnostic performance of axial and coronal views in multidetector-row CT (MDCT) of patients with small and large bowel obstruction.

MDCT images of 57 patients with surgical correlation for bowel obstruction were retrospectively evaluated. Portal-venous contrast-enhanced MDCT axial acquisition, performed by using 4x2.5 mm collimation, was followed by coronal recostruction using equal slice thickness of 2.5 mm with 2 mm increment. Three radiologists independently analyzed axial, coronal and axial plus coronal images in order to identify site and cause of bowel obstruction, according to a four-point confidence scale (1:certain; 2:probable; 3:possible; 4:excluded). MDCT findings of each reading session and for each reader were compared with surgical results. Sensitivity, specificity, and time of reading were calculated.

The Wilcoxon signed-rank test revealed significantly higher sensitivity for axial than coronal views (p=0.033) when dealing with small bowel obstruction, whereas no differences were found when considering large bowel obstruction. According to Student's t test, all readers interpreted axial slices combined with coronal reconstructions with a significantly higher level of confidence (p=0.0019) than axial or coronal views alone. The mean time for interpreting axial slices was statistically significantly longer than that obtained for coronal views (10.2 vs 8.7 minutes; p=0.0096). When combined axial and coronal views were analyzed, the mean time spent on reading was longer than that spent for axial images alone (11.5 vs 10.2 minutes; p=0.083), but differences were not statistically significant.

Axial slices resulted superior to coronal views thanks to a better sensitivity in patients with small bowel obstruction. The combined reading of axial and coronal views significantly improved diagnostic confidence, without a significant increase of reading time.

Grassedonio, E, Cianci, R, Di Fabio, F, Filippone, A, Multidetector-Row CT in Bowel Obstruction: Comparison of Axial and Coronal Views Diagnostic Performance.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4419507.html