Bowel luminal fluid and wall attenuation on unenhanced ct for predicting small bowel necrosis
Main Article Content
Abstract
This multicenter retrospective diagnostic study evaluated the value of increased bowel luminal fluid and bowel wall attenuation on unenhanced computed tomography (CT) for predicting bowel necrosis in patients with strangulated small bowel obstruction. Fifty-five surgically treated patients were included, comprising 8 patients with bowel necrosis and 47 without necrosis. Attenuation was measured at the suspected affected loop and a non-dilated reference loop, and the attenuation increase was calculated as the difference in Hounsfield units. The necrosis group showed significantly greater increases in bowel luminal fluid and bowel wall attenuation than the non-necrosis group (12.0 vs. 2.0 HU and 12.0 vs. 3.0 HU, respectively; p < 0.001). The corresponding areas under the curve were 0.991 and 0.918. At a cutoff of 7.5 HU, bowel luminal fluid attenuation increase achieved 100% sensitivity and 95.7% specificity, whereas bowel wall attenuation increase achieved 87.5% sensitivity and 100% specificity. These objective quantitative parameters may complement routine CT interpretation when assessed together with contrast-enhanced CT findings and clinical context.
Article Details
Keywords
Small bowel obstruction, bowel necrosis, computed tomography, bowel luminal fluid attenuation, bowel wall attenuation, strangulation
References
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