Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Medicine School of Nanjing University, Nanjing, 210002, China.
Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Abdom Radiol (NY). 2018 Nov;43(11):2955-2962. doi: 10.1007/s00261-018-1597-x.
To evaluate the feasibility and accuracy of remnant small intestinal length measured by barium follow-through (BaFT) examination and three-dimensional CT enterography (CTe).
Twenty-nine consecutive short bowel syndrome patients (SBS) who underwent BaFT, CTe, and prior surgical measurements of small intestine were included. Measurements of total remnant small intestinal length on BaFT and CTe were compared to surgical measurements using Spearman's rank correlation coefficients, Bland-Altman plots, and paired t test.
The average remnant intestinal length was 73.1 ± 37.2 cm according to surgical measurement. There was a significant positive correlation between CTe and surgical measurement (r = 0.99; p < 0.0001), and a relatively weaker correlation between BaFT and surgical measurement (r = 0.71; p < 0.001). Compared with surgical measurement, the percentage differences of CTe and BaFT were 5.71 ± 6.71% and 27.14 ± 18.41% (mean ± SD), respectively. Furthermore, Bland-Altman plots showed good agreement between CTe and surgical measurement, whereas relatively poor agreement between BaFT and surgical measurement. However, significant difference was found among the three measurement methods by paired t test (p < 0.0001).
Assessment of remnant small intestinal length by CTe is accurate and acceptable for clinical application, whereas BaFT is less accurate although BaFT is more convenient and cheaper for clinical application. And CTe can provide a cost-effective and noninvasive determination of remnant small intestinal length in planning surgical and nutritional intervention in SBS patients.
评估钡剂小肠造影（BaFT）检查和三维 CT 肠造影（CTe）测量残留小肠长度的可行性和准确性。
连续纳入 29 例短肠综合征（SBS）患者，这些患者均接受过 BaFT、CTe 和小肠术前测量。采用 Spearman 秩相关系数、Bland-Altman 图和配对 t 检验比较 BaFT 和 CTe 上的总残留小肠长度测量值与手术测量值。
根据手术测量，平均残留肠长度为 73.1±37.2cm。CTe 与手术测量呈显著正相关（r=0.99；p<0.0001），BaFT 与手术测量相关性较弱（r=0.71；p<0.001）。与手术测量相比，CTe 和 BaFT 的百分比差异分别为 5.71%±6.71%和 27.14%±18.41%（均值±标准差）。此外，Bland-Altman 图显示 CTe 与手术测量具有良好的一致性，而 BaFT 与手术测量的一致性相对较差。然而，配对 t 检验显示三种测量方法之间存在显著差异（p<0.0001）。
CTe 评估残留小肠长度准确，可用于临床应用，而 BaFT 虽然在临床应用中更方便、更经济，但准确性较低。CTe 可在计划 SBS 患者的手术和营养干预时提供一种经济有效的残留小肠长度的非侵入性确定方法。
