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Abdominal Radiology

, Volume 43, Issue 11, pp 3157–3165 | Cite as

Classification of spontaneous isolated superior mesenteric artery dissection: correlation with multi-detector CT features and clinical presentation

  • Jeongin Yoo
  • Jong Beum Lee
  • Hyun Jeong Park
  • Eun Sun Lee
  • Sung Bin Park
  • Yang Soo Kim
  • Byung Ihn Choi
Article
  • 68 Downloads

Abstract

Purpose

The purpose of the study is to propose a computed tomography (CT) classification of spontaneous isolated superior mesenteric artery dissection (SISMAD) correlated with clinical presentation

Methods

We retrospectively reviewed CT images of 40 patients with SISMAD at our institution from 2006 to 2015 and proposed a new classification: type I, patent false lumen with both entry and re-entry; type II, patent false lumen without re-entry; type III, completely or partially thrombosed false lumen; and type IV, thrombosed false lumen with ulcer-like projection. Additionally, we included a subtype (S) at each type when there was either a long segment of dissection and/or significant true lumen stenosis. CT features were statistically analyzed using Fisher’s exact and Mann–Whitney test.

Results

The CT findings classified patients as type I (15%), type II (12.5%), type III (35%), and type IV (37.5%). Of the 40 patients, 25 (62.5%) were symptomatic. There was a significantly different proportion of each type between symptomatic and asymptomatic patients (p = 0.005). There were 25 patients with subtype (S); no type I or II, 12 type III, and 13 type IV. The symptomatic patients showed longer dissection tendency and more severe true lumen stenosis (78% vs. 53%, p = 0.000) compared with asymptomatic patients.

Conclusion

The proposed multi-detector CT classification of SISMAD correlates with clinical presentation. This new classification could be helpful for treatment planning.

Keywords

Mesenteric artery Superior Dissection Classification Multidetector computed tomography 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jeongin Yoo
    • 1
  • Jong Beum Lee
    • 1
  • Hyun Jeong Park
    • 1
  • Eun Sun Lee
    • 1
  • Sung Bin Park
    • 1
  • Yang Soo Kim
    • 1
  • Byung Ihn Choi
    • 1
  1. 1.Department of RadiologyChung-Ang University HospitalSeoulKorea

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