Value of Multi-Detector Row Spiral CT and 3-Dimensional Reconstruction Technique for Intussusception_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Guangwen , SONG Bin , CHEN Litao , WU Bi , LI Zhenlin

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, ChinaCorresponding Author: SONG Bin, E-mail: ajr.songbin@vip.163.com;

Corresponding author：

Keywords：

Intussusception; Tomography/X-ray computed; Reconstruction; Confidence index

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To investigate the value of the multi-detector row spiral CT (MDCT) and 3-dimensional reconstruction technique for adult intussusception.
Methods 　Twenty-one patients with surgically and clinical following-up confirmed intussusception were retrospectively included into this study. Three patients had plain MDCT scan, 18 received contrast enhanced MDCT scan. The original images were reconstructed with multi-planar reconstruction (MPR) technique and all the images of 21 patients were divided into original image group and original image add MPR image group. Two abdominal radiologists analyzed the MDCT imaging and recorded respectively the accuracy rate and the confidence index of the doctor about following indexes: whether or not having intussusception, the location of intussusception, finding reason caused intussusception, whether or not having bowel wall ischemia and whether or not having bowel obstruction. The accuracy rate and the confidence index of the doctor were compared using a SPSS statistics software.
Results 　The accuracy rates about above indexes between original image group and original image add MPR image group were 90.5% (19/21) vs. 100% (21/21), 81.0% (17/21) vs. 95.2% (20/21), 85.7% (18/21) vs. 90.5% (19/21), 90.9% (10/11) vs. 90.9% (10/11) and 100% (11/11) vs. 100% (11/11) respectively, and there was no significant difference between original image group and original image add MPR image group (P gt;0.05). For following indexes: whether or not having intussusception, the location of intussusception, finding reason caused intussusception, the confidence index of the doctor between original image add MPR image group and original image group had significant difference (5.00 vs. 4.24, 4.76 vs. 4.29, 4.29 vs. 3.71), and the confidence index of the doctor of original image add MPR image group exceeded that of original image group (P lt;0.05).
Conclusions 　MDCT plays a valuable role in diagnosis and location of intussusception, finding the reason caused intussusception and evaluation the hemodynamic impairment of being involved in bowel wall. Compared to simple axial image, axial image combine 3-dimensional reconstructed image can increase the diagnostic confidence of the doctor.

Citation： CHEN Guangwen,SONG Bin,CHEN Litao,WU Bi,LI Zhenlin. Value of Multi-Detector Row Spiral CT and 3-Dimensional Reconstruction Technique for Intussusception. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(10): 856-860. doi: Copy

1.	Boudiaf M, Jaff A, Soyer P, et al. Small-bowel diseases: prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients [Ｊ]. Radiology, 2004; 233(2): 338-344.
2.	Kim HC, Yang DM, Jin W, et al. Added diagnostic value of multiplanar reformation of multidetector CT data in patients with suspected appendicitis [Ｊ]. Radiographics, 2008; 28(2): 393-405.
3.	Hoeffel C, Crema MD, Belkacem A, et al. Multi-detector row CT: spectrum of diseases involving the ileocecal area [Ｊ]. Radiographics, 2006; 26(5): 1373-1390.
4.	石海峰, 杨小庆, 杨明. 64排螺旋CT后处理技术诊断机械性肠梗阻 [Ｊ]. 中国医学影像技术, 2009; 25(1): 103-106.
5.	伍兵，闵鹏秋, 宋彬, 等. 多排螺旋CT在诊断胃癌侵犯胃裸区中的价值 [Ｊ]. 中国普外基础与临床杂志, 2005; 12 (4): 411-414.
6.	朱炯, 龚红霞, 庄治国, 等. 多层螺旋CT在肠道肿瘤诊断中的价值 [Ｊ]. 上海交通大学学报(医学版), 2008; 28(8): 937-940.
7.	刘文瑾, 张云, 刘锦萍, 等. 多层螺旋CT 多平面重建诊断急性肠梗阻病因的价值 [Ｊ]. 临床放射学杂志, 2006; 25(5): 439-442.
8.	徐洪恩, 吴恩福, 郑祥武, 等. 多层螺旋CT薄层及多平面重组技术在成人肠套叠诊断中的应用 [Ｊ]. 中华放射学杂志, 2007; 41(6): 615-618.
9.	Marinis A, Yiallourou A, Samanides L, et al. Intussusception of the bowel in adults: a review [Ｊ]. World J Gastroenterol, 2009; 15(4): 407-411.
10.	Choi SH, Han JK, Kim SH, et al. Intussusception in ad-ults: from stomach to rectum [Ｊ]. AJR Am J Roentgenol, 2004; 183(3): 691-698.
11.	许传军, 李晓东, 刘林祥, 等. 多层螺旋CT及多平面重组技术在成人肠套叠病因诊断中的应用价值 [Ｊ]. 第三军医大学学报, 2008; 30(20): 1962-1963.
12.	纪建松, 章士正, 邵初晓, 等. 螺旋CT对成人肠套叠的诊断及临床意义 [Ｊ]. 中华医学杂志, 2007; 87(16): 1129-1132.
13.	d’Almeida M, Jose J, Oneto J, et al. Bowel wall thickening in children: CT findings [Ｊ]. Radiographics, 2008; 28(3): 727-746.
14.	陈光文, 宋彬, 吴苾. 肠壁增厚的CT表现及诊断意义 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(12): 943-949.
15.	Kim YH, Blake MA, Harisinghani MG, et al. Adult intestinal intussusception: CT appearances and identification of a causative lead point [Ｊ]. Radiographics, 2006; 26(3): 733-744.
16.	Yakan S, Caliskan C, Makay O, et al. Intussusception in ad-ults: clinical characteristics, diagnosis and operative strategies [Ｊ]. World J Gastroenterol, 2009; 15(16): 1985-1989.
17.	Lvoff N, Breiman RS, Coakley FV, et al. Distinguishing features of self-limiting adult small-bowel intussusception identified at CT [Ｊ]. Radiology, 2003; 227(1): 68-72.
18.	Fujimoto T, Fukuda T, Uetani M, et al. Unenhanced CT findings of vascular compromise in association with intussusceptions in adults [Ｊ]. AJR Am J Roentgenol, 2001; 176(5): 1167-1171.
19.	Chou CK, Wu RH, Mak CW, et al. Clinical significance of poor CT enhancement of the thickened small-bowel wall in patients with acute abdominal pain [Ｊ]. AJR Am J Roentgenol, 2006; 186(2): 491-498.
20.	陈海曦, 李征宇, 何之彦, 等. CT对急性成人肠套叠的临床诊断价值 [Ｊ]. 中国医学影像技术, 2004; 20(10): 1532-1534.
21.	Wittenberg J, Harisinghani MG, Jhaveri K, et al. Algorithmic approach to CT diagnosis of the abnormal bowel wall [Ｊ]. Radiographics, 2002; 22(5): 1093-1109.

1. Boudiaf M, Jaff A, Soyer P, et al. Small-bowel diseases: prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients [Ｊ]. Radiology, 2004; 233(2): 338-344.
2. Kim HC, Yang DM, Jin W, et al. Added diagnostic value of multiplanar reformation of multidetector CT data in patients with suspected appendicitis [Ｊ]. Radiographics, 2008; 28(2): 393-405.
3. Hoeffel C, Crema MD, Belkacem A, et al. Multi-detector row CT: spectrum of diseases involving the ileocecal area [Ｊ]. Radiographics, 2006; 26(5): 1373-1390.
4. 石海峰, 杨小庆, 杨明. 64排螺旋CT后处理技术诊断机械性肠梗阻 [Ｊ]. 中国医学影像技术, 2009; 25(1): 103-106.
5. 伍兵，闵鹏秋, 宋彬, 等. 多排螺旋CT在诊断胃癌侵犯胃裸区中的价值 [Ｊ]. 中国普外基础与临床杂志, 2005; 12 (4): 411-414.
6. 朱炯, 龚红霞, 庄治国, 等. 多层螺旋CT在肠道肿瘤诊断中的价值 [Ｊ]. 上海交通大学学报(医学版), 2008; 28(8): 937-940.
7. 刘文瑾, 张云, 刘锦萍, 等. 多层螺旋CT 多平面重建诊断急性肠梗阻病因的价值 [Ｊ]. 临床放射学杂志, 2006; 25(5): 439-442.
8. 徐洪恩, 吴恩福, 郑祥武, 等. 多层螺旋CT薄层及多平面重组技术在成人肠套叠诊断中的应用 [Ｊ]. 中华放射学杂志, 2007; 41(6): 615-618.
9. Marinis A, Yiallourou A, Samanides L, et al. Intussusception of the bowel in adults: a review [Ｊ]. World J Gastroenterol, 2009; 15(4): 407-411.
10. Choi SH, Han JK, Kim SH, et al. Intussusception in ad-ults: from stomach to rectum [Ｊ]. AJR Am J Roentgenol, 2004; 183(3): 691-698.
11. 许传军, 李晓东, 刘林祥, 等. 多层螺旋CT及多平面重组技术在成人肠套叠病因诊断中的应用价值 [Ｊ]. 第三军医大学学报, 2008; 30(20): 1962-1963.
12. 纪建松, 章士正, 邵初晓, 等. 螺旋CT对成人肠套叠的诊断及临床意义 [Ｊ]. 中华医学杂志, 2007; 87(16): 1129-1132.
13. d’Almeida M, Jose J, Oneto J, et al. Bowel wall thickening in children: CT findings [Ｊ]. Radiographics, 2008; 28(3): 727-746.
14. 陈光文, 宋彬, 吴苾. 肠壁增厚的CT表现及诊断意义 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(12): 943-949.
15. Kim YH, Blake MA, Harisinghani MG, et al. Adult intestinal intussusception: CT appearances and identification of a causative lead point [Ｊ]. Radiographics, 2006; 26(3): 733-744.
16. Yakan S, Caliskan C, Makay O, et al. Intussusception in ad-ults: clinical characteristics, diagnosis and operative strategies [Ｊ]. World J Gastroenterol, 2009; 15(16): 1985-1989.
17. Lvoff N, Breiman RS, Coakley FV, et al. Distinguishing features of self-limiting adult small-bowel intussusception identified at CT [Ｊ]. Radiology, 2003; 227(1): 68-72.
18. Fujimoto T, Fukuda T, Uetani M, et al. Unenhanced CT findings of vascular compromise in association with intussusceptions in adults [Ｊ]. AJR Am J Roentgenol, 2001; 176(5): 1167-1171.
19. Chou CK, Wu RH, Mak CW, et al. Clinical significance of poor CT enhancement of the thickened small-bowel wall in patients with acute abdominal pain [Ｊ]. AJR Am J Roentgenol, 2006; 186(2): 491-498.
20. 陈海曦, 李征宇, 何之彦, 等. CT对急性成人肠套叠的临床诊断价值 [Ｊ]. 中国医学影像技术, 2004; 20(10): 1532-1534.
21. Wittenberg J, Harisinghani MG, Jhaveri K, et al. Algorithmic approach to CT diagnosis of the abnormal bowel wall [Ｊ]. Radiographics, 2002; 22(5): 1093-1109.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Value of Multi-Detector Row Spiral CT and 3-Dimensional Reconstruction Technique for Intussusception

Abstract Full text Figures/Tables Video References Cited by

Format

Content