Maglinte D D, Reyes B L, Harmon B H, Kelvin F M, Turner W W, Hage J E, Ng A C, Chua G T, Gage S N
Department of Radiology, Methodist Hosptial of Indiana, Indianapolis 46202, USA.
AJR Am J Roentgenol. 1996 Dec;167(6):1451-5. doi: 10.2214/ajr.167.6.8956576.
We compare the reliability and define the role of plain film radiography and CT in the assessment of various severities of small-bowel obstruction.
A blinded retrospective analysis was done on 78 patients who underwent plain abdominal radiography, CT, and enteroclysis to assess for suspected small-bowel obstruction. The findings at enteroclysis and the clinical outcomes were used as standards of reference.
The sensitivity of plain film radiography for revealing small-bowel obstruction was 69% (44/64), and its specificity was 57% (8/14). Overall accuracy of plain film radiography was 67% (52/78). The sensitivity and specificity of CT were 64% (41/64) and 79% (11/ 14), respectively. Overall accuracy of CT was 67% (52/78). When obstructions were classified as low- and high-grade partial obstruction, plain film radiography and CT had sensitivities of 86% (24/28) and 82% (23/28), respectively, for high-grade obstruction and 56% (20/36) and 50% (18/36), respectively, for low-grade obstruction. CT revealed the cause of the small-bowel obstruction in 95% (39/41) of those patients in who CT correctly showed the obstruction.
Plain film radiography and CT had similar overall accuracies in showing small-bowel obstruction of various severities. Plain film radiography should remain the initial method of imaging patients with suspected small-bowel obstruction. The ability of CT to show the cause of small-bowel obstruction makes CT an important additional diagnostic tool when specific management issues must be addressed.
我们比较了X线平片和CT在评估不同严重程度小肠梗阻方面的可靠性，并明确其作用。
对78例因疑似小肠梗阻而接受腹部X线平片、CT及小肠灌肠造影检查的患者进行了盲法回顾性分析。以小肠灌肠造影的结果及临床结局作为参考标准。
X线平片显示小肠梗阻的敏感性为69%（44/64），特异性为57%（8/14）。X线平片的总体准确率为67%（52/78）。CT的敏感性和特异性分别为64%（41/64）和79%（11/14）。CT的总体准确率为67%（52/78）。当梗阻分为低位和高位不完全梗阻时，X线平片和CT对高位梗阻的敏感性分别为86%（24/28）和82%（23/28），对低位梗阻的敏感性分别为56%（20/36）和50%（18/36）。在CT正确显示梗阻的患者中，CT揭示了95%（39/41）患者的小肠梗阻病因。
X线平片和CT在显示不同严重程度小肠梗阻方面总体准确率相似。X线平片应仍是疑似小肠梗阻患者的初始影像学检查方法。CT能够显示小肠梗阻病因，这使得CT在必须解决特定治疗问题时成为一种重要的辅助诊断工具。
