Objective Evaluation of the Enhancement Effect in Contrast-enhanced Computed Tomography may be Useful for Diagnosis of Bowel Strangulation

Abstract

Introduction: Detection of bowel ischemia before the development of necrosis is necessary for accurate diagnosis of bowel strangulation (BS). We developed a new method by which to detect bowel ischemia, which involves revision of the computed tomographic value of the small intestine according to that of the superior mesenteric vein to obtain the intestinal wall-superior mesenteric vein contrast enhancement ratio (IVCER). Methods: Twenty patients with BS and 24 patients with simple ileus (SI) underwent enhanced computed tomography. We compared the values of the IVCER between the patients with BS and those with SI. Results: The IVCER was significantly lower in the patients with BS than that in the patients with SI. The sensitivity and specificity of IVCER for accurate diagnosis of BS were 0.95 and 0.83, respectively. Conclusion: Determination of the IVCER allows for objective evaluation of bowel enhancement and can lead to an accurate diagnosis of BS.