CT imaging indicators for the diagnosis of blunt hollow visceral and mesenteric injuries

YANG Xu-yang; ZHANG Yuan-chuan; DENG Xiang-bing; WEI Ming-tian; WANG Zi-qiang; ZHOU Zong-guang

Abstract：Objective Try to find imaging indicators for the diagnosis of blunt hollow visceral and mesen-teric injuries and to identify specific reliable CT features for diagnosis by comparing intraoperative findings and pre-operative signs of computed tomography ( CT ) . Methods A total of 100 blunt abdominal trauma patients ( 82 males and 18 females aged from 11 months to 77 years,mean age 37 years) from Jan.2011 to Dec.2013 in our hos-pital were enrolled and analyzed retrospectively.There were 50 patients confirmed by surgery of blunt hollow viscer-al and mesentery injuries ( group A) ,and 50 patients with mere solid abdominal organ injuries ( group B) .One-way ANOVA analysis was employed to test the sensitivity,specificity,positive likelihood ratio and negative likelihood rati-o of CT signs in the preoperative diagnosis.Results Twenty-five (50%) patients in group A had free intra-or ret-roperitoneal air,and 49(98%) patients in group B had either free intra-or retroperitoneal air(P<0.01).Sensitiv-ities of CT signs for preoperative diagnosis were statistically significant in regard to bowel wall thickening ( 40%) , mesentery thickening (42%),mesenteric density increasing (16%),abdominal fat density increasing (18%),and peritoneal thickening (26%).Meanwhile,several signs of CT had a high specificity for diagnosing blunt visceral and its mesentery injuries,such as bowel wall thickening(98%),mesentery thickening (88%),mesenteric density increasing( 98%),increased abdominal fat density (96%),and peritoneal thickening (90%).Conclusion Sev-eral signs of preoperative CT,such as free intra-or retroperitoneal air,bowel wall thickening,mesentery swelling,ele-vated mesenteric density,increased abdominal fat density,and peritoneal thickening are found to be candidate indica-tors for the diagnosis of small bowel injuries with an acceptable sensitivity and specificity.