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

Figure 4 Protocol 3 applied in a 72-year-old woman with an adenocarcinoma at the end of the small bowel causing small bowel obstruction. Because it was difficult to identify the relationship between the mass and the dilated small bowel loops by conventional axial and coronal reformations, the reader selectively performed multiple post-processing techniques. A and B: Multidetector computed tomography axial and coronal images of the abdomen reveal an irregular, obviously enhanced mass (arrows) with a size of 4.4 cm × 4.2 cm × 3.7 cm in the right lower abdomen, and the small bowel loops (pentagram) in the abdominal cavity are moderately dilated with a maximum diameter of 3.6 cm. C: Curved planar reformation image clearly shows the location of the mass (arrows), dilated proximal bowel loops (pentagram), and collapsed distal bowel loops (arrowheads). D and E: Maximum intensity projection and volume rendering (VR) images obtained in the arterial phase indicate the mass with distorted and enlarged neovascular structures (arrows) arising from the ileocolic branch (arrowheads) of the superior mesenteric artery. F: VR image obtained in the portal venous phase reveals an obviously stained mass (arrowheads) and lymph nodes (arrows) in the adjacent mesentery.