64-slice multidetector computed tomography evaluation of gastrointestinal tract perforation site: detectability of direct findings in upper and lower GI tract

Objective To evaluate wall discontinuity, as observed using 64-slice multidetector-row computed tomography (64-MDCT), as a direct finding (DF) indicating the perforation site in patients with gastrointestinal (GI) tract perforations. Methods We retrospectively studied 41 consecutive patients present...

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Bibliographic Details
Published in:European radiology 2010-06, Vol.20 (6), p.1396-1403
Main Authors: Oguro, Sota, Funabiki, Tomohiro, Hosoda, Koji, Inoue, Yukio, Yamane, Takashi, Sato, Michihiro, Kitano, Mitsuhide, Jinzaki, Masahiro
Format: Article
Language:English
Subjects:
Abdomen
Abdomen, Acute - diagnostic imaging
Abdomen, Acute - etiology
Accuracy
Adult
Aged
Aged, 80 and over
Computed Tomography
Diagnostic Radiology
Emergency medical care
Female
Gastrointestinal Tract - diagnostic imaging
Humans
Imaging
Internal Medicine
Interventional Radiology
Intestinal Perforation - complications
Intestinal Perforation - diagnostic imaging
Laparotomy
Male
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Pneumoperitoneum - diagnostic imaging
Pneumoperitoneum - etiology
Radiology
Reproducibility of Results
Rupture - complications
Rupture - diagnostic imaging
Sensitivity and Specificity
Tomography
Tomography, X-Ray Computed - methods
Ultrasound
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Summary:Objective To evaluate wall discontinuity, as observed using 64-slice multidetector-row computed tomography (64-MDCT), as a direct finding (DF) indicating the perforation site in patients with gastrointestinal (GI) tract perforations. Methods We retrospectively studied 41 consecutive patients presenting with acute abdomen and exhibiting extraluminal air (EA) on 64-MDCT. Three readers evaluated the distribution of EA, extraluminal faeces, dirty mass, dirty fat sign, extraluminal fluid collection and bowel wall thickening (i.e. conventional findings, CFs) as well as DFs. Results Twenty-two cases were surgically or endoscopically confirmed to have upper GI tract perforations, and 19 had lower GI tract perforations. The DFs correctly identified the sites of perforation in 80.5% of patients when 2-mm-thick imaging slices were used. For the detection of upper GI tract perforations, the sensitivity, specificity and accuracy were 95.5%, 94.7% and 95.1% for the DFs and 50.0%, 100% and 73.2% for the CFs, respectively. Significant differences in sensitivity ( p  
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-009-1670-5