The Value of 64 MDCT Angiography in the Diagnosis of the Small Bowel Volvulus

Objective To describe CT and CT angiography(CTA) findings of small bowel volvulus(SBV) and assess the value of CTA in diagnosing small intestine volvulusits.Materials and Methods CT and CTA findings in 8 patients with surgically proved SBV were retrospectively reviewed.CT plain scan and double phase enhance scan were performed in all the patients.All the data were transmited in a workstation and CTA reconstruction was performed.Two radiologists assesssed the location,direction and dimensionality of SBV based on CTA finding.Results The main signs of CT included 'whirlpool' of vessels(6 cases) and intestine(5cases),'target loop'(3 cases),'beak'(3 cases),reduced enhancement and edema of intestion wall(4 cases) and ascites(1 case).CTA showed normal appearance of the stem of superior mesenteric artery(SMA) in 5 cases.There were proximal SMA stem tortuosity and SMA tributaries tortuosity in one case respectively.SMA and superior mesenteric vein(SMV) relational twisting was showed in another case.Axially torsion and dilation of SMV stem were also observed in 4 cases.Meanwhile,tortuosity and abnormal distribution of SMV tributaries were observed in 3 cases.Dilation of SMV tributaries was also seen in 4 patients.Compared with operation,the location and direction of SBV were correctly judged in all the cases based on CTA.Dimensionality of SBV were correctly estimated by CTA in 5 cases but underestimated in 3 cases.Conclusion CTA plays an important role in diagnosis of SBV.CTA can estimate correctly the location and direction but was limited in estimating the dimensionality of SBV.