The role of multidetector computed tomograhy with multiplanar reconstruction in the evalution of intestinal obstruction

Aim of the study was to interpret the role of MDCT with MPR in the evaluation of the patiens who suspcected to have intestinal obstruction. Abdominal CT examination with 16-detector row MDCT was performed in 66 patients suspected to have intestinal obstruction after intravenous injection of iodinated contrast material without using oral contrast agent. Firstly, axial slices were evaluated for the presence, the level, the transition zone, the cause, the type and the degree and possible additional findings of intestinal obstruction. One month later MPR images of the same patients were re-evaluated randomly for the aforementioned findings and compared with each other. With axial slices, presence of obstruction was detected with 100% accuracy. Transition zone was found in 92% of cases. Obstruction level was small bowel in %77 of cases. The cause of obstruction was identified in 94% and the type of obstruction was determined in 95% of cases correctly. With MPR images, presence of obstruction was detected with 100% accuracy. Transition zone was found in 92% of cases. Obstruction level was small bowel in %77 of cases. The cause of obstruction was identified in 95% and the type of obstruction was determined in 95% of cases correctly. There was no statistically significant difference between axial slices and MPR images in term of the presence, the level, the transition zone, the cause, the type and the degree of intestinal obstruction. Although average confidence score was higher for all intestines and small bowel obstruction, this difference was not statistically significant. We also evaluated brid ileus patients if there are any MDCT findings that can help to differentiate patients who need surgery or not. We found that need for surgery was statistically higher in the patients who had complete and high grade incomplete obstruction than the patients who had low grade incomplete obstruction. As a result, our study confirms that MDCT provides accurate information to surgeon about the presence, the level, the cause and the type of intestinal obstruction, as well as to detect possible complications. MDCT studies with axial slices will provide sufficient information and confidence to the radiologist in terms of intestinal obstruction. The degree of obstruction is important to determine the possibility of operation in patients with brid ileus.