Literature DB >> 21191737

Interobserver agreement on the diagnosis of bowel ischemia: assessment using dynamic computed tomography of small bowel obstruction.

Koki Kato1, Kimiyoshi Mizunuma, Munehiro Sugiyama, Shunsuke Sugawara, Tomohiro Suzuki, Makiko Tomabechi, Toshiya Kariyasu, Taiki Fukuda.   

Abstract

PURPOSE: The aim of this study was to evaluate the accuracy and interobserver variability of dynamic computed tomography (CT) for diagnosis of small bowel obstruction. METHOD AND MATERIALS: A total of 115 patients with a CT diagnosis of small bowel obstruction were included. Two radiologists and two residents performed blinded, independent, retrospective reviews of CT studies. Attention was focused on the presence of reduced early enhancement of the bowel wall and closed loop obstruction. Results were correlated with surgical findings in 15 cases and clinical follow-up in 100 cases. Sensitivity and specificity were calculated, and kappa statistics were used to analyze interobserver agreement.
RESULTS: In all, 13 cases were surgically confirmed small bowel ischemia. Sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of ischemia were 85%, 96%-97%, 73%-79%, and 97%-98%, respectively, for radiologists and 69%-93%, 93%-95%, 63%-64%, and 96%-99%, respectively, for residents. For agreement in the interpretations of reduced early enhancement of bowel wall, closed loop obstruction, and presence of bowel ischemia, the values were 0.62, 0.71, and 0.80, respectively, between radiologists and 0.57-0.70, 0.63-0.74, and 0.56-0.68, respectively, between radiologists and residents.
CONCLUSION: There was moderate or substantial agreement for the diagnosis of small bowel ischemia between radiologists and residents. However, there was substantial agreement for the presence of closed loop obstruction.

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Year:  2010        PMID: 21191737     DOI: 10.1007/s11604-010-0500-7

Source DB:  PubMed          Journal:  Jpn J Radiol        ISSN: 1867-1071            Impact factor:   2.374


  22 in total

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