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La radiologia medica

, 116:829 | Cite as

Seven-Tesla micro-MRI in early detection of acute arterial ischaemia: evolution of findings in an in vivo rat model

  • D. Berritto
  • F. Somma
  • N. Landi
  • C. Cavaliere
  • M. Corona
  • S. Russo
  • F. Fulciniti
  • S. Cappabianca
  • A. Rotondo
  • R. Grassi
Experimental Radiology / Radiologia Sperimentale

Abstract

Purpos

Acute mesenteric ischaemia (AMI) is a life-threatening vascular emergency with a high mortality rate. Early diagnosis is the key to reducing its mortality rate and improving the quality of life. Although computed tomography (CT) is still the gold standard for acute intestinal disorders, over the last few years, magnetic resonance imaging (MRI) has become a useful alternative tool. An animal model of AMI was developed in order to study the effectiveness of MRI in early detection of this condition and to observe lesion evolution.

Methods

Thirty Sprague Dawley rats were randomly divided into two groups (n=15): in the first group, after laparotomy, the animals underwent ligation of the superior mesenteric artery (SMA), followed by macroscopic monitoring and histological evaluation; in the second, ischaemia was induced by squeezing a loop around the SMA 3 days before evaluation with 7-T micro-MRI.

Results

Macroscopically, a refl ex spastic ileus followed by refl ex hypotonic ileus and colour changes in some of the loops were detected. MRI evidenced luminal dilatation with air-fluid levels, free intraperitoneal fluid and bowelwall oedema. Histological analysis confirmed ischaemia and earlier damage involving the central portion of the ileum.

Conclusions

This model shows the correct sequence of events during arterial AMI and demonstrates that MRI can be recommended for early diagnosis of these lesions.

Keywords

Experimental model Acute bowel ischaemia Micro-MRI Pathology 

Micro-RM a 7 T nella diagnosi precoce di ischemia mesenterica acuta ad eziologia arteriosa: cronologia dei reperti in modello animale in vivo

Riassunto

Obiettivo

L’ischemia mesenterica acuta (IMA) rappresenta un’emergenza vascolare ad elevata mortalità. La diagnosi precoce è imprescindibile per migliorare sopravvivenza e qualità di vita dei pazienti. Sebbene attualmente la tomografia computerizzata (TC) rimane la metodica di scelta nelle patologie intestinali acute, negli ultimi anni la risonanza magnetica (RM) si è proposta come valida alternativa. Per valutare l’efficacia della RM nella diagnosi precoce di IMA ed investigare l’evoluzione delle lesioni è stato utilizzato un modello animale di ischemia mesenterica.

Materiali e metodi

Trenta ratti Sprague-Dawley sono stati divisi casualmente in 2 gruppi (n=15): nel primo, dopo legatura dell’arteria mesenterica superiore (AMS) in laparotomia, le lesioni sono state monitorate macroscopicamente e istopatologicamente; nel secondo, grazie ad un cappio posizionato all’emergenza dell’AMS tre giorni prima, è stata indotta l’ischemia e valutata con micro-RM a 7 T.

Risultati

Macroscopicamente si è osservato un ileo rifl esso spastico, transitato poi in ipotono, ed il viraggio cromatico di alcune anse. La RM ha documentato la dilatazione luminale con livelli idro-aerei, liquido libero intraperitoneale ed edema parietale. L’analisi istopatologica ha confermato l’ischemia con danno più precoce a carico dell’ileo centrale.

Conclusioni

Il modello documenta la corretta sequenza degli eventi dell’ischemia mesenterica arteriosa acuta (IMAA) e dimostra che la RM può essere proposta per la sua diagnosi precoce.

Parole chiave

Modello sperimentale Ischemia intestinale acuta Micro-RM Anatomia patologica 

References/Bibliografia

  1. 1.
    Yasuhara H (2005) Acute mesenteric ischemia: the challenge of gastroenterology. Surg Today 35:185–195PubMedCrossRefGoogle Scholar
  2. 2.
    Berland T, Oldenburg WA (2008) Acute mesenteric ischemia. A clinical review. Curr Gastroenerol Rep 10:341–346CrossRefGoogle Scholar
  3. 3.
    Andersson R, Parsson H, Isaksson B, Norgen L (1984) Acute intestinal ischemia. A 14-year retrospective investigation. Acta Chir Scand 150:217–221PubMedGoogle Scholar
  4. 4.
    Mamode N, Pickford I, Leibmerman P (1999) Failure to improve outcome in acute mesenteric ischaemia: seven-year review. Eur J Surg 165:203–208PubMedCrossRefGoogle Scholar
  5. 5.
    Endean ED, Barnes SL, Kwolek CJ et al (2001) Surgical management of thrombotic acute intestinal ischemia. Ann Surg 233:801–808PubMedCrossRefGoogle Scholar
  6. 6.
    Dahlke MH, Asshoff L, Popp FC et al (2008) Mesenteric ischemia-outcome after surgical therapy in 83 patients. Dig Surg 25:213–219PubMedCrossRefGoogle Scholar
  7. 7.
    Angelelli G, Scardapane A, Memeo M et al (2004) Acute bowel ischemia: CT findings. Eur J Radiol 50:37–47PubMedCrossRefGoogle Scholar
  8. 8.
    Schoots IG, Koffeman GI, Legamate DA et al (2004) Systematic review of survival after acute mesenteric ischaemia according to disease aetiology. Br J Surg 91:17–27PubMedCrossRefGoogle Scholar
  9. 9.
    Oldenburg WA, Lau LL, Rodenberg TJ et al (2004) Acute mesenteric ischemia: a clinical review. Arch Intern Med 164:1054–1062PubMedCrossRefGoogle Scholar
  10. 10.
    Sreenarasimhaiah J (2003) Diagnosis and management of intestinal ischaemic disorders. BMJ 326:1372–1376PubMedCrossRefGoogle Scholar
  11. 11.
    Hammond NA, Miller FH, Yaghmai V et al (2008) MR imaging of acute bowel pathology: a pictorial review. Emerg Radiol 15:99–104PubMedCrossRefGoogle Scholar
  12. 12.
    Martin DR, Danrad R, Herrmann K et al (2005) Magnetic resonance imaging of the gastrointestinal tract. Top Magn Reson Imaging 16:77–98PubMedCrossRefGoogle Scholar
  13. 13.
    Mitsudo S, Brandt LJ (1992) Pathology of intestinal ischemia. Surg Clin North Am 72:43–63PubMedGoogle Scholar
  14. 14.
    Chiu CJ, McArdle AH, Brown R et al (1970) Intestinal mucosal lesion in low-flow states. I. A morphological, hemodynamic, and metabolic reappraisal. Arch Surg 101:478–483PubMedGoogle Scholar
  15. 15.
    Notohamiprodjo M, Baumeister Rg, Jakobs TF et al (2009) MR lymphangiography at 3.0 T — A feasibility study. Eur Radiol 19:2771–2778PubMedCrossRefGoogle Scholar
  16. 16.
    Grassi R, Cavaliere C, Cozzolino S et al (2009) Small animal imaging facility: new perspectives for the radiologist Radiol Med 114:152–167PubMedCrossRefGoogle Scholar
  17. 17.
    Bartnicke BJ, Balfe DM (1994) CT appearance of intestinal ischemia and intramural hemorrhage. Radiol Clin North Am 32:845–860PubMedGoogle Scholar
  18. 18.
    Grassi R, Pinto A, Romano L et al (1997) Twenty-six consecutive patients with acute superior mesenteric infarction. Comparison of conventional radiology, ultrasonography, and computerized tomography. Radiol Med 93:699–703PubMedGoogle Scholar
  19. 19.
    Wiesner W, Khurana B, Ji H, Ros PR (2003) CT of acute bowel ischemia. Radiology 226:635–650PubMedCrossRefGoogle Scholar
  20. 20.
    Alpern MB, Glazer G, Francis IR (1988) Ischemic or infarcted bowel: CT findings. Radiology 166:149–152PubMedGoogle Scholar
  21. 21.
    Klein HM, Lensing R, Klosterhalfen B et al (1995) Diagnostic imaging of mesenteric infarction. Radiology 197:79–82PubMedGoogle Scholar
  22. 22.
    Taourel PG, Deneuville M, Pradel JA et al (1996) Acute mesenteric ischemia: diagnosis with contrast-enhanced CT. Radiology 199:632–636PubMedGoogle Scholar
  23. 23.
    Salzano A, De Rosa A, Carbone M et al (1999) Computerized tomography features of intestinal infarction: 56 surgically treated patients of which 5 with reversible mesenteric ischemia. Radiol Med 97:246–250PubMedGoogle Scholar
  24. 24.
    Balthazar EJ, Yen BC, Gordon RB (1999) Ischemic colitis: CT evaluation of 54 cases. Radiology 211:381–388PubMedGoogle Scholar
  25. 25.
    Zalcman M, Sy M, Donckier V, Closset J, Van Gansbeke D (2000) Helical CT signs in the diagnosis of intestinal ischemia in small-bowel obstruction. AJR 175:1601–1607PubMedGoogle Scholar
  26. 26.
    Fujimoto T, Fukuda T, Uetani M et al (2001) Unenhanced CT findings of vascular compromise in association with intussusceptions in adults. AJR 176:1167–1171PubMedGoogle Scholar
  27. 27.
    Kirkpatrick ID, Kroeker MA, Greenberg HM (2003) Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia: initial experience. Radiology 229:91–98PubMedCrossRefGoogle Scholar
  28. 28.
    Klein HM, Klosterhalfen B, Kinzel S et al (1996) CT and MRI of experimentally induced mesenteric ischemia in a porcine model. J Comput Assist Tomogr 20:254–261PubMedCrossRefGoogle Scholar
  29. 29.
    Kim MY, Suh CH, Kim ST et al (2004) Magnetic resonance imaging of bowel ischemia induced by ligation of superior mesenteric artery and vein in a cat model. J Comput Assist Tomogr 28:187–192PubMedCrossRefGoogle Scholar
  30. 30.
    Lassandro F, Scaglione M, Rossi G et al (2002) Portomesenteric vein gas: diagnostic and prognostic value. Emerg Radiol 9:96–99PubMedGoogle Scholar
  31. 31.
    Moschetta M, Stabile Ianora AA, Pedote P et al (2009) Prognostic value of multidetector computed tomography in bowel infarction. Radiol Med 114:780–791PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • D. Berritto
    • 1
  • F. Somma
    • 1
  • N. Landi
    • 1
  • C. Cavaliere
    • 1
  • M. Corona
    • 2
  • S. Russo
    • 3
  • F. Fulciniti
    • 4
  • S. Cappabianca
    • 1
  • A. Rotondo
    • 1
  • R. Grassi
    • 1
  1. 1.Institute of RadiologySecond University of NaplesNaplesItaly
  2. 2.Biotechnology CentreA.O.R.N.Cardarelli, NaplesItaly
  3. 3.Department of Pathology“Maresca” HospitalNaplesItaly
  4. 4.Cytopathology Service, Section of Pathology, Department of SurgeryNational Cancer CentreFondazione G. Pascale, NaplesItaly

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