Tomoko Kanzaki1, Jiro Hata2, Hiroshi Imamura2, Noriaki Manabe2, Kazuhide Okei3, Hiroaki Kusunoki4, Tomoari Kamada5, Akiko Shiotani5, Ken Haruma5. 1. Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. ttokkok7@hotmail.com. 2. Division of Endoscopy and Ultrasound, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. 3. Department of Natural Sciences, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. 4. Department of General Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. 5. Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
Abstract
PURPOSE: To determine the usefulness of contrast-enhanced ultrasonography with the contrast agent Sonazoid™ for the detection of bowel ischemia. METHODS: From March 2007 to February 2009, 65 patients (35 men and 30 women, mean age 70.4 ± 16.1 years) were enrolled. Fifty-three patients complained of acute abdominal pain with small bowel dilatation (n = 40) or reduced bowel peristalsis (n = 13). Twelve patients were clinically suspected of having bowel ischemia. After Sonazoid™ injection, bowel segments were scanned using harmonic imaging, and the signal intensities were classified as normal or diminished. The definitive diagnosis was confirmed by surgery in 30 patients, autopsy in 6, endoscopy in 3, angiography in 1, and clinical follow-up in 25. RESULTS: All 50 patients with normal signal intensities were confirmed not to have bowel ischemia. In the 15 patients with diminished signal intensities, 14 patients were confirmed to have bowel ischemia, resulting in an overall sensitivity of 100% [95% confidence interval (CI) 80.7-100%], a specificity of 98% [95% CI 89.5-99.9%], a positive predictive value of 93% (95% CI 68.1-99.8%), and a negative predictive value of 100% (95% CI 94.1-100%). CONCLUSION: Contrast-enhanced ultrasonography with Sonazoid™ is a highly sensitive and specific method for the diagnosis of bowel ischemia.
PURPOSE: To determine the usefulness of contrast-enhanced ultrasonography with the contrast agent Sonazoid™ for the detection of bowel ischemia. METHODS: From March 2007 to February 2009, 65 patients (35 men and 30 women, mean age 70.4 ± 16.1 years) were enrolled. Fifty-three patients complained of acute abdominal pain with small bowel dilatation (n = 40) or reduced bowel peristalsis (n = 13). Twelve patients were clinically suspected of having bowel ischemia. After Sonazoid™ injection, bowel segments were scanned using harmonic imaging, and the signal intensities were classified as normal or diminished. The definitive diagnosis was confirmed by surgery in 30 patients, autopsy in 6, endoscopy in 3, angiography in 1, and clinical follow-up in 25. RESULTS: All 50 patients with normal signal intensities were confirmed not to have bowel ischemia. In the 15 patients with diminished signal intensities, 14 patients were confirmed to have bowel ischemia, resulting in an overall sensitivity of 100% [95% confidence interval (CI) 80.7-100%], a specificity of 98% [95% CI 89.5-99.9%], a positive predictive value of 93% (95% CI 68.1-99.8%), and a negative predictive value of 100% (95% CI 94.1-100%). CONCLUSION: Contrast-enhanced ultrasonography with Sonazoid™ is a highly sensitive and specific method for the diagnosis of bowel ischemia.
Authors: H K Ha; J S Kim; M S Lee; H J Lee; Y K Jeong; P N Kim; M G Lee; K W Kim; M Y Kim; Y H Auh Journal: Radiology Date: 1997-08 Impact factor: 11.105
Authors: H Okanobu; J Hata; K Haruma; S Matsumura; S Yoshida; Y Kitadai; S Tanaka; K Chayama Journal: Scand J Gastroenterol Date: 2002-05 Impact factor: 2.423