Hodel Jerome, Zins Marc, Desmottes Loic, Boulay-Coletta Isabelle, Jullès Marie Christine, Nakache Jean Pierre, Rodallec Mathieu
Department of Radiology, Saint Joseph Hospital, Paris, France.
Abdom Imaging. 2009 Jan-Feb;34(1):35-41. doi: 10.1007/s00261-007-9348-4.
To assess the additional value of multiplanar reformations (MPR) in comparison with axial images alone for location of the transition zone in CT of mechanical small-bowel obstruction (SBO).
Sixty-nine consecutive patients with mechanical SBO underwent 16-slice multi detector row CT (MDCT). The gold standard for the precise location of the transition zone was established by two experienced abdominal radiologists, unblinded to clinical and surgical reports, reviewing all CT examinations. On a workstation, two blinded readers independently located the transition zone using first axial slices alone and then 1 month later MPR (axial, coronal, sagittal and oblique views) according to a three-point confidence scale. Diagnostic accuracy and mean confidence score were evaluated for both the transverse and multiplanar data sets.
Accuracy of transition zone location for reader 1 and reader 2 was 86% and 84% with axial slices alone, and by using MPR 93% (significant: P = 0.03) and 90% (not significant: P = 0.08), respectively. Mean confidence score was significantly increased for both readers using MPR: 0.3 higher (P = 0.0001) and 0.37 higher (P = 0.0001) respectively.
MPR can increase both accuracy and confidence in the location of the transition zone in CT of SBO.
评估在机械性小肠梗阻（SBO）的CT检查中，多平面重建（MPR）相较于单纯轴位图像在确定移行带位置方面的附加价值。
69例连续性机械性SBO患者接受了16层多排螺旋CT（MDCT）检查。由两名经验丰富的腹部放射科医生在不了解临床和手术报告的情况下，对所有CT检查进行回顾，以此确立移行带精确定位的金标准。在工作站上，两名不知情的阅片者先仅使用轴位图像，然后在1个月后使用MPR（轴位、冠状位、矢状位和斜位视图），根据三点置信度量表独立确定移行带的位置。对横断位和多平面数据集的诊断准确性和平均置信度评分进行评估。
阅片者1和阅片者2仅使用轴位图像时，移行带定位的准确率分别为86%和84%，而使用MPR时分别为93%（P = 0.03，具有显著性）和90%（P = 0.08，无显著性）。两名阅片者使用MPR时的平均置信度评分均显著提高：分别提高0.3（P = 0.0001）和0.37（P = 0.0001）。
MPR可提高SBO的CT检查中移行带定位的准确性和置信度。
