Hyun Soo Kim, Presenter: Nothing to Disclose

Sung Eun Ahn, Abstract Co-Author: Nothing to Disclose

Dong Ho Lee MD, Abstract Co-Author: Nothing to Disclose

Seong Jin Park MD, PhD, Abstract Co-Author: Nothing to Disclose

Joo Won Lim, Abstract Co-Author: Nothing to Disclose

Han Na Lee MD, Abstract Co-Author: Nothing to Disclose

Sung Kyoung Moon, Abstract Co-Author: Nothing to Disclose

Yunkyung Shin, Abstract Co-Author: Nothing to Disclose

To evaluate the imaging predictive factors and clinical factors of bowel viability and prognosis in abdomen CT of the patients with bowel ischemia.

This retrospective study enrolled 72 patients (M:F ratio = 35:37, mean age = 63.2 years) who underwent abdomen CT due to bowel ischemia or infarction. Two radiologists reviewed two phase abdomen CT images without information of their recovery status in consensus. The following imaging features were assessed; involving bowel location, involving pattern (multifocal, continuous), involving length (<25cm, 25~50cm, 50~75cm, >75cm), thickness of the most thickened bowel, mucosal and mural enhancement degrees (absence, decreased, similar to the adjacent viable bowel, increased), mucosa and serosa disruption, delayed enhancement of mucosa and serosa, ancillary findings (mesentery vessel thrombosis, other organ infarction, portal vein gas, and pneumatosis). Statistical analyses were performed for the comparison between good and poor prognosis patients by using Chi-square, Fisher’s exact and paired-T tests.

According to the clinical data, patients were divided into two groups – group 1 who underwent the bowel resection, or were expired (12), and group 2 who recovered bowel viability with conservative manage (60). In comparison between 2 groups, small bowel involvement, longer segment involvement, decreased mucosal and mural enhancement degrees, and the presence of mucosal disruption, mesenteric vessel thrombosis, and other abdominal organs infarction were statistically related to the poor clinical results (p <0.05). Of the 23 patients who showed lack or decreased mucosal enhancement of involved bowel, small bowel involvement (p<0.001) and involved length (p= 0.013) were statistically associated with the prognosis.

Significant CT findings related to the prognosis in bowel ischemia are small bowel involvement, longer segment involvement, decreased mucosal and mural enhancement, mucosal layer disruption, mesenteric vessel thrombosis, other abdominal organs infarction.

When the ischemic bowel showed absent or decreased mucosal enhancement in abdomen CT, small bowel and long length involvement is the bed prognostic factor requiring the prompt and active treatment.

Kim, H, Ahn, S, Lee, D, Park, S, Lim, J, Lee, H, Moon, S, Shin, Y, What Is the Predictive Factors of Bowel Viability and Prognosis in Bowel Ischemia? Retrospective Review of Image Findings of Abdomen Computed Tomography (CT).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013084.html