Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, The Netherlands.
Jpn J Radiol. 2011 Jan;29(1):11-8. doi: 10.1007/s11604-010-0508-z. Epub 2011 Jan 26.
The aim of this study was to determine the feasibility of cine magnetic resonance imaging (MRI) for diagnosing strangulated small bowel obstruction (SBO).
This study included 38 patients with clinically confirmed SBO who had undergone cine MRI. Cine MRI scans were evaluated regarding the presence of the "peristalsis gap sign" (referring to an akinetic or severely hypokinetic closed loop), indicating strangulation. Computed tomography (CT) was performed in 34 of 38 patients with (n = 25) or without (n = 9) contrast enhancement. CT images were evaluated using a combination of criteria (presence of hyperattenuation, poor contrast enhancement, mesenteric edema, wall thickening, massive ascites) indicating strangulation. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of cine MRI and CT for the diagnosis of strangulation were calculated and compared using surgical findings and the clinical course as the reference standard.
Sensitivity, specificity, PPV, and NPV of cine MRI were 100%, 92.9%, 83.3%, and 100%, respectively; and those of CT (of which 26.5% was performed without contrast enhancement) were 66.7%, 92.0%, 75.0%, and 88.5%, respectively. There was no significant difference in diagnostic accuracy between the two methods (P = 0.375).
Cine MRI is a feasible and promising technique for diagnosing strangulation.
本研究旨在确定电影磁共振成像（MRI）诊断绞窄性小肠梗阻（SBO）的可行性。
本研究纳入了 38 例经临床证实的 SBO 患者，这些患者均接受了电影 MRI 检查。评估电影 MRI 扫描中是否存在“蠕动间隙征”（提示为无蠕动或严重低动力的闭袢），以确定绞窄的存在。38 例患者中有 34 例（n=25）或无（n=9）对比增强进行了 CT 检查。使用（存在高信号、对比增强不良、肠系膜水肿、壁增厚、大量腹水）等综合标准评估 CT 图像，以确定绞窄的存在。使用手术结果和临床过程作为参考标准，计算并比较电影 MRI 和 CT 对绞窄诊断的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
电影 MRI 的敏感性、特异性、PPV 和 NPV 分别为 100%、92.9%、83.3%和 100%；而 CT（其中 26.5%未行对比增强）的敏感性、特异性、PPV 和 NPV 分别为 66.7%、92.0%、75.0%和 88.5%。两种方法的诊断准确性无显著差异（P=0.375）。
电影 MRI 是一种可行且有前途的诊断绞窄的技术。
