Can CT Features Be Used to Diagnose Surgical Adult Bowel Intussusceptions?
July 21st, 2009 Posted by: admin
OBJECTIVE. The purpose of our study was to identify whether any CT
characteristics can be used to diagnose surgical intussusceptions.
MATERIALS AND METHODS. A search of CT reports on adults revealed 118
patients with 136 intussusceptions. Two blinded readers independently reviewed
the CT examinations and documented intussusception characteristics. Medical
records were reviewed to determine patient outcome. Performance, interobserver
agreement (A), and significance of CT characteristics to identify surgical
intussusceptions were calculated.
RESULTS. Of 95,223 CT examinations, 0.13% (121/95,223) documented
136 intussusceptions over a 7-year period, of which 88.2% (120/136) were
enteroenteric, 3.7% (5/136) were enterocolic, and 4.4% (6/136) were colocolic
lesions or in other locations. Eight (5.9%) were surgical and 128 (94.12%)
were nonsurgical lesions. Five of eight (63%) surgical lesions involved the
colon. Only two of eight surgical lesions had malignant lead points. The mean
sensitivity, specificity, positive predictive value, and negative predictive
value for diagnosing surgical enteroenteric lesions using a measured lesion
length of > 3.5 cm were 100%, 57.3%, 5.7%, and 100% (A = 0.68),
respectively. Similar figures using the measured axial diameter > 3 cm were
100%, 32.9%, 3.7% and 100% (A= 0.65), respectively.
CONCLUSION. Surgical intussusceptions in adults are infrequent among
the intussusceptions that are detected on CT. Most enteroenteric lesions are
nonsurgical lesions, whereas lesions that affect the colon are often surgical.
Many nonsurgical enteroenteric intussusceptions are longer than 3.5 cm and
thicker than 3 cm, suggesting these CT features may not be useful for
diagnosing surgical bowel intussusceptions in adults.
