Abstract
Purpose
Diagnosis of non-occlusive mesenteric ischemia (NOMI) is difficult, with diagnostic imaging being mainly performed using angiography or contrast-enhanced computed tomography. Contrast-enhanced ultrasonography (CEUS) offers an alternative diagnostic method, although diagnosis of NOMI using CEUS is not common. In this report, we review CEUS findings in a series of patients with NOMI.
Methods
The records of patients diagnosed with NOMI who underwent a surgical procedure in our institution between January 2015 and February 2020 were retrospectively assessed. Grayscale ultrasonography and CEUS findings were evaluated.
Results
Ten patients (mean age 65 ± 25 years, 7 men) were studied. Grayscale ultrasonography revealed bowel dilatation, the presence of intestinal pneumatosis, portal venous gas, bowel wall thickening, and no or decreased peristalsis. A CEUS finding of note was a partial lack of enhancement of the bowel wall.
Conclusion
In a small case series of 10 patients with surgically/histopathology confirmed NOMI, partial lack of ultrasound contrast-enhancement of the bowel wall was observed.
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Conceptualization: JH. Data curation: HI, JH, TT. Formal analysis: HI. Investigation: HI. Methodology: HI, JH. Project administration: HI, JH. Supervision: JH. Validation: HI. Visualization: HI. Writing: HI.
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Approval was obtained from the ethics committee of Kawasaki Medical School (Ethics approval number: 2768).
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Ethical approval was waived by the ethics committee of Kawasaki Medica School in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.
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Movie 1: Contrast-enhanced ultrasonographic video from a patient with non-occlusive mesenteric ischemia. Contrast-enhanced ultrasonography shows a partial and discontinuous lack of enhancement of the bowel wall, and arterial flow entering the ischemic lesion is maintained in the middle of video. (MP4 137522 KB)
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Imamura, H., Hata, J. & Takata, T. Contrast-enhanced ultrasonographic findings of non-occlusive mesenteric ischemia: a case series. Abdom Radiol 47, 1654–1659 (2022). https://doi.org/10.1007/s00261-021-03002-1
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DOI: https://doi.org/10.1007/s00261-021-03002-1