Diagnosis of adult midgut malrotation in CT: sign of absent retromesenteric duodenum reliable.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Insights into Imaging Pub Date : 2025-02-17 DOI:10.1186/s13244-025-01921-x

Min Yang, Shaokun Zheng, Jian Shu, Zhenwei Yao

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引用次数: 0

Abstract

Objectives: To compare the incidence of absent retromesenteric duodenum with other radiological signs and to assess its diagnostic significance for midgut malrotation in adults.

Methods: This IRB-approved retrospective single-center study involved adult patients who underwent abdominal CT scans. Patients were screened for the presence of the absent retromesenteric duodenum sign. Signs observed included the position of the duodenal-jejunal junction (DJJ) and jejunum within the abdomen, the relationship between the superior mesenteric artery (SMA) and superior mesenteric vein (SMV), the locations of the ascending colon, cecum, and appendix, and the presence of intestinal volvulus.

Results: A total of 5594 patients were included. Seven patients exhibited the sign of absent retromesenteric duodenum. Four of these patients were identified as those diagnosed with midgut malrotation in the past five years. The common features observed in all 11 patients were: the horizontal segment of the duodenum did not traverse behind the SMA but instead curved rightwards and forwards adjacent to it; the DJJ and jejunum were positioned in the right abdomen; the SMV was anterior to the SMA. In 7 patients (7/11), the ascending colon, cecum, and appendix were located in the left abdomen. 5 patients (5/11) showed a high cecum position, and 2 patients (2/11) exhibited a pelvic appendix.

Conclusion: The absent retromesenteric duodenum sign in CT diagnosis of adult midgut malrotation has proven to be more reliable.

Critical relevance statement: Radiologists should routinely identify the course of the duodenum horizontal segment in CT images, to prevent misdiagnosis of adult midgut malrotation.

Key points: CT is suitable for the diagnosis of adult midgut malrotation. Absent retromesenteric duodenum for diagnosing adult midgut malrotation is more reliable than other signs. Diagnostic CT criteria for adult midgut malrotation need updating.

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.