Optimized protocol of multiple post-processing techniques improves diagnostic accuracy of multidetector computed tomography in assessment of small bowel obstruction compared with conventional axial and coronal reformations

Table 1 Worksheet for readers to use for interpretation of multidetector computed tomography post-processing images

Presence or absence of obstruction	External hernias
Presence (≥ 2.5 cm)	Bezoars/stones
Absence (< 2.5 cm)	Vascular lesions
Severity of obstruction	Inflammatory lesions
Mild (2.5 to < 3 cm)	Others (e.g., foreign body, abdominal cocoon, hematoma and so on)
Moderate (3 to < 4 cm)	Findings of secondary bowel ischemia
Severe (≥ 4 cm)	Main sings
Obstruction site	Increased bowel wall attenuation
Proximal (duodenum to proximal jejunum)	Decreased bowel wall enhancement
Middle (distal jejunum to mid-ileum)	Vascular embolus/thrombosis
Distal (distal ileum)	Vascular stenosis/occlusion
Multisegmental (more than one segment)	Pneumatosis/portomesenteric gas
Cause	Secondary sings
Adhesions	Bowel wall thickening
Neoplasms	Increased bowel wall enhancement
Intussusception	Mesenteric fluid/haziness
Neoplasms	Mesenteric vascular engorgement
Non-neoplasms	Small bowel feces sign
Volvulus	Ascites
Hernias	Others (solid organ infarction, free gas and so on)
Internal hernias	Other findings (fistula, leakage or perforation, pneumoperitoneum and so on)