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Three-dimensional CT enterography versus barium follow-through examination in measurement of remnant small intestinal length in short bowel syndrome patients

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Abstract

Purpose

To evaluate the feasibility and accuracy of remnant small intestinal length measured by barium follow-through (BaFT) examination and three-dimensional CT enterography (CTe).

Materials and methods

Twenty-nine consecutive short bowel syndrome patients (SBS) who underwent BaFT, CTe, and prior surgical measurements of small intestine were included. Measurements of total remnant small intestinal length on BaFT and CTe were compared to surgical measurements using Spearman's rank correlation coefficients, Bland–Altman plots, and paired t test.

Results

The average remnant intestinal length was 73.1 ± 37.2 cm according to surgical measurement. There was a significant positive correlation between CTe and surgical measurement (r2 = 0.99; p < 0.0001), and a relatively weaker correlation between BaFT and surgical measurement (r2 = 0.71; p < 0.001). Compared with surgical measurement, the percentage differences of CTe and BaFT were 5.71 ± 6.71% and 27.14 ± 18.41% (mean ± SD), respectively. Furthermore, Bland–Altman plots showed good agreement between CTe and surgical measurement, whereas relatively poor agreement between BaFT and surgical measurement. However, significant difference was found among the three measurement methods by paired t test (p < 0.0001).

Conclusions

Assessment of remnant small intestinal length by CTe is accurate and acceptable for clinical application, whereas BaFT is less accurate although BaFT is more convenient and cheaper for clinical application. And CTe can provide a cost-effective and noninvasive determination of remnant small intestinal length in planning surgical and nutritional intervention in SBS patients.

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Abbreviations

SBS:

Short bowel syndrome

BaFT:

Barium follow-through

CTe:

CT enterography

MDCT:

Multidetector CT

STEP:

Serial transverse enteroplasty procedure

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Acknowledgements

This study was funded by the Chinese National Natural Science Foundation (Grant No. 81270945).

Author information

Author notes

  1. Wei Cheng and Shaoyi Zhang are co-first authors.

Authors and Affiliations

  1. Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Medicine School of Nanjing University, Nanjing, 210002, China

    Wei Cheng, Shaoyi Zhang, Jian Wang, Yousheng Li & Jieshou Li

  2. Department of General Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Shaoyi Zhang & Yousheng Li

  3. Department of Medical Imaging, Jinling Hospital, Medicine School of Nanjing University, Nanjing, 210002, China

    Changsheng Zhou

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  1. Wei Cheng
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  6. Jieshou Li
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Correspondence to Yousheng Li.

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Funding

This study was funded by the Chinese National Natural Science Foundation (Grant No. 81270945).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethics committee of Jinling Hospital. All the participants provided written informed consent.

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Cheng, W., Zhang, S., Wang, J. et al. Three-dimensional CT enterography versus barium follow-through examination in measurement of remnant small intestinal length in short bowel syndrome patients. Abdom Radiol 43, 2955–2962 (2018). https://doi.org/10.1007/s00261-018-1597-x

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