To explore the changes of D-dimer (D-D), intestinal fatty acid-binding protein (I-FABP) and the characteristics of CT angiography (CTA) in patients with ischemic bowel disease (ICBD).

A retrospective analysis was conducted on the clinical data of 204 patients with suspected ICBD admitted to Nanjing Gaochun People's Hospital from March 2022 to March 2024. According to the pathological results, patients diagnosed with ICBD were included in the ICBD group, and those diagnosed with non-ICBD were included in the non-ICBD group. The CTA characteristics, D-D and I-FABP levels of all subjects were collected, the differences in the above indicators between the two groups were compared. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of CTA characteristics, D-D and I-FABP in diagnosing ICBD and the area under the curve (AUC).

Among the 204 suspected ICBD patients included in this study, 104 cases were pathologically diagnosed, and the CTA examination signs showed that 60 cases (57.69%) involved the small intestine, 34 cases (32.69%) involved the colon, and 10 cases (9.62%) involved both the large and small intestines. Among them, there were 88 cases (84.62%) of intestinal wall thickening, 16 cases (15.38%) of intestinal wall gas accumulation, 52 cases (50.00%) of intestinal dilation, 78 cases (75.00%) of weakened intestinal wall enhancement, 30 cases (28.85%) of peritoneal effusion, 6 cases (5.77%) of mesenteric edema, and 8 cases (7.69%) of intestinal obstruction. The difference in the positive rate of imaging features between the two groups by Fisher's exact probability method was statistically significant (P<0.05). The levels of D-D and I-FABP in the ICBD group were higher than those in the non-ICBD group (P<0.05). The ROC curve showed that the AUC for I-FABP, D-D, and CTA imaging scores were 0.808, 0.783 and 0.776. The diagnostic efficacy of I-FABP for ICBD was significantly better than that of D-D and the image score, the diagnostic efficacy of D-D for ICBD was slightly higher than that of the image score, and the AUC of the three combined was 0.905. The Delon test showed that the AUC of the combined model was significantly higher than that of I-FABP (Z=3.87, P<0.001), D-D (Z=4.52, P<0.001), and CTA image score (Z=4.91, P<0.001), while there was no statistically significant difference among the single indicators (all P>0.0083).

The combined model of D-D, I-FABP changes and CTA characteristics in patients with ICBD improves the accuracy of early diagnosis and provides new basis for condition assessment and treatment plan formulation of ICBD.