• Henry C K Kwok, Ilse Dirkzwager, David S Duncan, Michael J Gillham, and David G Milne.
• Department of Diagnostic Radiology, Auckland District Health Board, Auckland, New Zealand. DMilne@adhb.govt.nz.
• Crit Care Resusc. 2014 Jun 1;16(2):90-5.

ObjectiveTo determine the accuracy of multidetector computed tomography (MDCT) in the diagnosis of nonocclusive mesenteric ischaemia (NOMI) among patients after cardiovascular surgery.Design, Setting And ParticipantsA retrospective review of 38 patients in a cardiothoracic intensive care unit who underwent MDCT examination before laparotomy for suspected NOMI between January 2001 and December 2012.Intervention And Main Outcome MeasuresThe MDCT studies were examined independently by three radiologists, who were asked to make a determination on the presence or absence of NOMI. The radiological diagnosis was compared against the surgical and/or histological outcome to determine the diagnostic accuracy of MDCT.ResultsThe sensitivity and specificity of MDCT in the diagnosis of NOMI were 96% and 33%-60%, respectively. The positive and negative likelihood ratios and diagnostic odds ratio were 1.43-2.39, 0.072-0.13 and 11-33.2, respectively. The inter-rater agreement was 68%, with a Fleiss κ of 0.43.ConclusionsMDCT has high sensitivity but lacks specificity in the diagnosis of NOMI. Its main value is in selection of patients for non-operative management, at least in the short-to-medium term.

35 keywords...

hide…