View in EDS HTML Full Text PDF Full Text

External validation of a CT score for predicting ischaemia in adhesive small-bowel obstruction.

Saved in:
Bibliographic Details
Title: External validation of a CT score for predicting ischaemia in adhesive small-bowel obstruction.
Authors: Vadot, Valentin1 (AUTHOR), Guiraud, Adeline2 (AUTHOR), Kalilou Sow, Amadou3 (AUTHOR), Fournel, Isabelle3 (AUTHOR), Simon, Gabriel4 (AUTHOR), Acquier, Adrien1 (AUTHOR), Mvouama, Ségolène1 (AUTHOR), Chevallier, Olivier1,5 (AUTHOR), Ortega-Deballon, Pablo2 (AUTHOR), Loffroy, Romaric1,5 (AUTHOR) romaric.loffroy@chu-dijon.fr
Source: European Radiology. Jul2025, Vol. 35 Issue 7, p4203-4212. 10p.
Subjects: Ischemia, Computed tomography, Surgery, Bowel obstructions, Inter-observer reliability, Retrospective studies, Diagnosis
Abstract: Objectives: To assess the diagnostic accuracy, in a validation cohort, of a score based on three CT items, which has shown good performance for predicting ischaemia complicating acute adhesive small-bowel obstruction (SBO). Methods: This retrospective single-centre study of diagnostic accuracy included consecutive patients admitted for acute adhesive SBO in 2015–2022, who were treated conservatively or underwent surgery within 24 h after CT. The gold standard for ischaemia was an intraoperative diagnosis for operated patients, while the absence of ischaemia was confirmed either by its absence during surgery or by clinical follow-up in patients who did not undergo surgery. Three radiologists independently assessed the three score items, namely, decreased bowel-wall enhancement, diffuse mesenteric haziness, and closed-loop mechanism. Inter-observer agreement was evaluated by computing Fleiss' kappa. The diagnostic performance characteristics of the score were computed. Results: Of the 164 patients analysed (median age, 70 [57–80] years; 88 [54%] males), 57 (34.8%) had surgery, including 41 (71.9%) with intra-operative evidence of bowel ischaemia, whereas 107 (65.2%) were treated conservatively. A score ≥ 2/3 had a sensitivity of 78% (95% CI: 62–89%), a specificity of 97% (95% CI: 92–99%), a positive predictive value of 89% (95% CI: 74–97%), and a positive likelihood ratio of 24 (95% CI: 9.03–63.79). Adding increased unenhanced bowel-wall attenuation and requiring ≥ 2/4 items did not improve score performance. Fleiss' kappa values indicated moderate to substantial agreement between observers: 0.64 [0.56–0.73] for decreased bowel-wall enhancement, 0.57 [0.48–0.66] for diffuse mesenteric haziness, and 0.68 [0.59–0.76] for closed-loop mechanism. Conclusions: The results of this external validation study support the reproducibility and good diagnostic performance of the score based on three CT items for predicting bowel ischaemia complicating acute adhesive SBO. Key Points: QuestionThe Millet score with three enhanced CT items for predicting bowel ischaemia complicating acute adhesive SBO has not been assessed in an external validation cohort. FindingsAdding "increased unenhanced bowel-wall attenuation" to the "decreased bowel-wall enhancement", "diffuse mesenteric haziness", and "closed-loop mechanism" items did not improve score performance. Clinical relevanceIn an external validation cohort, a score based on three CT items performed well for predicting ischaemia in patients with acute adhesive SBO and showed acceptable inter-observer agreement. This score may help identify patients for surgery. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Engineering Source
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
Text:
  Availability: 1
Header DbId: egs
DbLabel: Engineering Source
An: 185942244
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: External validation of a CT score for predicting ischaemia in adhesive small-bowel obstruction.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Vadot%2C+Valentin%22">Vadot, Valentin</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Guiraud%2C+Adeline%22">Guiraud, Adeline</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kalilou+Sow%2C+Amadou%22">Kalilou Sow, Amadou</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fournel%2C+Isabelle%22">Fournel, Isabelle</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Simon%2C+Gabriel%22">Simon, Gabriel</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Acquier%2C+Adrien%22">Acquier, Adrien</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mvouama%2C+Ségolène%22">Mvouama, Ségolène</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chevallier%2C+Olivier%22">Chevallier, Olivier</searchLink><relatesTo>1,5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ortega-Deballon%2C+Pablo%22">Ortega-Deballon, Pablo</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Loffroy%2C+Romaric%22">Loffroy, Romaric</searchLink><relatesTo>1,5</relatesTo> (AUTHOR)<i> romaric.loffroy@chu-dijon.fr</i>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Jul2025, Vol. 35 Issue 7, p4203-4212. 10p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Ischemia%22">Ischemia</searchLink><br /><searchLink fieldCode="DE" term="%22Computed+tomography%22">Computed tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Surgery%22">Surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Bowel+obstructions%22">Bowel obstructions</searchLink><br /><searchLink fieldCode="DE" term="%22Inter-observer+reliability%22">Inter-observer reliability</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis%22">Diagnosis</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objectives: To assess the diagnostic accuracy, in a validation cohort, of a score based on three CT items, which has shown good performance for predicting ischaemia complicating acute adhesive small-bowel obstruction (SBO). Methods: This retrospective single-centre study of diagnostic accuracy included consecutive patients admitted for acute adhesive SBO in 2015–2022, who were treated conservatively or underwent surgery within 24 h after CT. The gold standard for ischaemia was an intraoperative diagnosis for operated patients, while the absence of ischaemia was confirmed either by its absence during surgery or by clinical follow-up in patients who did not undergo surgery. Three radiologists independently assessed the three score items, namely, decreased bowel-wall enhancement, diffuse mesenteric haziness, and closed-loop mechanism. Inter-observer agreement was evaluated by computing Fleiss' kappa. The diagnostic performance characteristics of the score were computed. Results: Of the 164 patients analysed (median age, 70 [57–80] years; 88 [54%] males), 57 (34.8%) had surgery, including 41 (71.9%) with intra-operative evidence of bowel ischaemia, whereas 107 (65.2%) were treated conservatively. A score ≥ 2/3 had a sensitivity of 78% (95% CI: 62–89%), a specificity of 97% (95% CI: 92–99%), a positive predictive value of 89% (95% CI: 74–97%), and a positive likelihood ratio of 24 (95% CI: 9.03–63.79). Adding increased unenhanced bowel-wall attenuation and requiring ≥ 2/4 items did not improve score performance. Fleiss' kappa values indicated moderate to substantial agreement between observers: 0.64 [0.56–0.73] for decreased bowel-wall enhancement, 0.57 [0.48–0.66] for diffuse mesenteric haziness, and 0.68 [0.59–0.76] for closed-loop mechanism. Conclusions: The results of this external validation study support the reproducibility and good diagnostic performance of the score based on three CT items for predicting bowel ischaemia complicating acute adhesive SBO. Key Points: QuestionThe Millet score with three enhanced CT items for predicting bowel ischaemia complicating acute adhesive SBO has not been assessed in an external validation cohort. FindingsAdding "increased unenhanced bowel-wall attenuation" to the "decreased bowel-wall enhancement", "diffuse mesenteric haziness", and "closed-loop mechanism" items did not improve score performance. Clinical relevanceIn an external validation cohort, a score based on three CT items performed well for predicting ischaemia in patients with acute adhesive SBO and showed acceptable inter-observer agreement. This score may help identify patients for surgery. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=185942244
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1007/s00330-025-11362-1
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 10
        StartPage: 4203
    Subjects:
      – SubjectFull: Ischemia
        Type: general
      – SubjectFull: Computed tomography
        Type: general
      – SubjectFull: Surgery
        Type: general
      – SubjectFull: Bowel obstructions
        Type: general
      – SubjectFull: Inter-observer reliability
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Diagnosis
        Type: general
    Titles:
      – TitleFull: External validation of a CT score for predicting ischaemia in adhesive small-bowel obstruction.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Vadot, Valentin
      – PersonEntity:
          Name:
            NameFull: Guiraud, Adeline
      – PersonEntity:
          Name:
            NameFull: Kalilou Sow, Amadou
      – PersonEntity:
          Name:
            NameFull: Fournel, Isabelle
      – PersonEntity:
          Name:
            NameFull: Simon, Gabriel
      – PersonEntity:
          Name:
            NameFull: Acquier, Adrien
      – PersonEntity:
          Name:
            NameFull: Mvouama, Ségolène
      – PersonEntity:
          Name:
            NameFull: Chevallier, Olivier
      – PersonEntity:
          Name:
            NameFull: Ortega-Deballon, Pablo
      – PersonEntity:
          Name:
            NameFull: Loffroy, Romaric
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 07
              Text: Jul2025
              Type: published
              Y: 2025
          Identifiers:
            – Type: issn-print
              Value: 09387994
          Numbering:
            – Type: volume
              Value: 35
            – Type: issue
              Value: 7
          Titles:
            – TitleFull: European Radiology
              Type: main
ResultId 1