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Case Studies | Radiology and Medical Imaging Sciences | India | Volume 13 Issue 2, February 2024
Correlation of Ultrasonography and Computed Tomography Findings of Bowel Lesions
Jaydeep Sukhadiya | Jagruti Sutariya | Ankitkumar Patel | Anjana Trivedi [4]
Abstract: Introduction: This was retrospective - perspective study to evaluate USG and CT finding of bowel lesion and correlation between them. Technological advancement in USG and CT has changed diagnostic accuracy and approach to intestinal lesion?s diagnosis. In the last few decades, the introduction of a non - invasive cross sectional imaging techniques including Ultrasound (US), Computed Tomography (CT) have changed the diagnostic approach to the bowel pathologies. ULTRASOUND: Among the imaging modalities ultrasound is less invasive, more comfortable for the patient and has a significant diagnostic accuracy. Modern ultrasound devices with high - frequency (high resolution) probes and harmonic imaging significantly improve examination of bowel by offering better overall image quality, better visualization of bowel pathology and associated changes in real time ("live anatomy"). Unlike to other cross sectional imaging technique, USG is able to evaluate bowel wall peristalsis, compressibility, Wall vascularity and probe tenderness. Computed Tomography: The development of multi - detector CT (MD - CT) scanner with rapid acquisition of thin slices and multi planar reconstruction allows detailed investigation of intestinal loops. Intravenous contrast together with distension of intestinal lumen by water or contrast agents is very useful in the detection of inflammatory and neoplastic intestinal pathologies as well as in the evaluation of extra - intestinal involvement (mesenteric lymph nodes, matted bowel loops, sinus/fistulas). Advances in MDCT with multi planer (MPR) and 3 - Dimensional (3D) reformat capabilities allows the demonstration of pathological processes involving the bowel wall, bowel lumen, mesentery, mesenteric vessels and peritoneal cavity. Therefore knowledge and awareness of the valuable 3D CT features and proper application technique of MDCT are very useful to achieve the accurate diagnostic goal of one step imaging. Objectives: 1) To study the role of USG and MDCT in suspicion of bowel pathologies. 2) To determine accuracy of MDCT in comparison to USG in evaluation of bowel lesions. To study the imaging characteristic of bowel lesions by using both modalities and to narrow down the differential diagnosis. Materials & Methods:100 patients were evaluated in this study conducted at tertiary care hospital (P. D. U. medical hospital, Rajkot), from October 2020 to April 2022 over a period of 1? years. USG was performed on Samsung RS80 - EVO high end machine and CT was performed using GE bright speed 16 slice MDCT machine. Results: Non neoplastic lesions are more prevalent as compared to neoplastic lesions. Colorectal malignancies are more common than small bowel malignancy and most of them will involve the recto sigmoid region of large intestine. CT has more accurate and superior results as compared to USG in detecting intestinal malignancy. CT appears to be the modality of choice to demonstrate the wide spectrum of findings seen in abdominal tuberculosis. Conclusion: Ultrasonographic examination has provided real time correlation between clinical symptoms and sonographic appearance of examined bowel segment (maximal tenderness, resistance, compressibility, presence or absence of peristalsis). CT scan is more accurate in diagnosing fat stranding and extra luminal complications like strictures, fistulas or abscess as compared to USG which is more common in chronic idiopathic inflammatory disease. CT is more specific for detection of small intestinal lesions as compared to USG.
Keywords: USG, MDCT, bowel lesions, intestinal malignancy
Edition: Volume 13 Issue 2, February 2024,
Pages: 1501 - 1506