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Adult intestinal intussusception: can abdominal MDCT distinguish an intussusception caused by a lead point?

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Abstract

Background

Aim of our study was to assess the ability of computed tomography to distinguish between an intussusception with a lead-point from one without it.

Methods

Approval was granted by the Institutional Review Board. Ninety-three consecutive patients diagnosed with an intussusception on abdominal CT were classified with or without lead-point by surgery, clinical or radiological follow-up. Two radiologists blinded to the classification independently reviewed the CT images for predefined predictive variables.

Results

Non-lead-point intussusception was shorter in length (mean 4.9 vs. 11.1 cm for Reader 1 (R1); mean 4.0 vs. 8.9 cm for Reader 2 (R2), respectively, P < 0.001), smaller in axial diameter (mean 3.0 vs. 4.8 cm for R1; mean 2.8 vs. 4.4 cm for R2, P < 0.001, respectively), less likely associated with obstruction (P = 0.002 R1; P = 0.039 R2) and infiltration (P < 0.001 for R1, P = 0.003 R2) than lead-point intussusception.

Conclusions

Abdominal CT is helpful in distinguishing between an intussusception with a lead-point from one without a lead-point. Length, axial diameter, and their product, as well as obstruction and infiltration, all suggest the presence of a lead-point. Analysis of CT findings can reduce unnecessary imaging follow-up or operation.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, San Paolo Hospital, University of Milan, Via A. Di Rudinì 8, Milan, 20142, Italy

    Silvia Tresoldi

  2. Department of Radiology, Umass Memorial Medical Center, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA

    Young H. Kim & Krishna Kandarpa

  3. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA

    Michael A. Blake, Mukesh G. Harisinghani, Peter F. Hahn & Peter R. Mueller

  4. IS Bioinformatics Unit, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA

    Stephen P. Baker

Authors
  1. Silvia Tresoldi
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  2. Young H. Kim
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  3. Michael A. Blake
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  4. Mukesh G. Harisinghani
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  5. Peter F. Hahn
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  6. Stephen P. Baker
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  7. Peter R. Mueller
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  8. Krishna Kandarpa
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Correspondence to Young H. Kim.

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Tresoldi, S., Kim, Y.H., Blake, M.A. et al. Adult intestinal intussusception: can abdominal MDCT distinguish an intussusception caused by a lead point?. Abdom Imaging 33, 582–588 (2008). https://doi.org/10.1007/s00261-007-9328-8

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  • DOI: https://doi.org/10.1007/s00261-007-9328-8

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