• Koki Kato, Kimiyoshi Mizunuma, Munehiro Sugiyama, Shunsuke Sugawara, Tomohiro Suzuki, Makiko Tomabechi, Toshiya Kariyasu, and Taiki Fukuda.
• Department of Radiology, Ohtawara Red Cross Hospital, 2-7-3 Sumiyoshi-cho, Ohtawara, 324-8686, Japan. katok357862@sea.plala.or.jp
• Jpn J Radiol. 2010 Dec 1; 28 (10): 727-32.

PurposeThe aim of this study was to evaluate the accuracy and interobserver variability of dynamic computed tomography (CT) for diagnosis of small bowel obstruction.Method And MaterialsA total of 115 patients with a CT diagnosis of small bowel obstruction were included. Two radiologists and two residents performed blinded, independent, retrospective reviews of CT studies. Attention was focused on the presence of reduced early enhancement of the bowel wall and closed loop obstruction. Results were correlated with surgical findings in 15 cases and clinical follow-up in 100 cases. Sensitivity and specificity were calculated, and kappa statistics were used to analyze interobserver agreement.ResultsIn all, 13 cases were surgically confirmed small bowel ischemia. Sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of ischemia were 85%, 96%-97%, 73%-79%, and 97%-98%, respectively, for radiologists and 69%-93%, 93%-95%, 63%-64%, and 96%-99%, respectively, for residents. For agreement in the interpretations of reduced early enhancement of bowel wall, closed loop obstruction, and presence of bowel ischemia, the values were 0.62, 0.71, and 0.80, respectively, between radiologists and 0.57-0.70, 0.63-0.74, and 0.56-0.68, respectively, between radiologists and residents.ConclusionThere was moderate or substantial agreement for the diagnosis of small bowel ischemia between radiologists and residents. However, there was substantial agreement for the presence of closed loop obstruction.

27 keywords...

hide…