Skip to main content

Advertisement

Log in

Multidetector CT angiography in the evaluation of acute mesenteric ischemia

  • Computer Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The aim of this study was to determine the accuracy of multidetector row CT angiography in the diagnosis of acute mesenteric ischemia. Ninety-three consecutive studies on 91 patients with clinically suspected acute mesenteric ischemia underwent abdominal CT angiography as the first, and usually the sole, diagnostic procedure. CT was performed with a multidetector 16-row CT system from the level of the diaphragm to the pelvis in two phases: early arterial and late portal phase. CT examinations were reviewed by the duty radiologist. Final diagnosis was established by a senior radiologist. CTA was diagnostic in 92 studies. Mesenteric ischemia was diagnosed in 18 patients, 14 of them were of the thromboembolic type and four from the nonocclusive type. Positive CTA findings were confirmed by surgery in 13 patients and by clinical follow-up in three cases. Other reasons for abdominal pain were diagnosed by CT in 38 patients out of the remaining 74. There were two false positive and two false negative CT results, resulting in an overall accuracy of 95.6%. Multidetector CT angiography is a fast and accurate investigation for the diagnosis of acute mesenteric ischemia and in most cases can be used as the sole diagnostic procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Park WM, Gloviczki P, Cherry KJ et al (2002) Contemporary management of acute mesenteric ischemia: factors associated with survival. J Vasc Surg 35:445–452

    Article  PubMed  Google Scholar 

  2. McKinsey JM, Gewertz BL (1997) Acute mesenteric ischemia. In: Schwartz LB, Gewertz BL (eds) The surgical clinics of North America - mesenteric ischemia, 1st edn. WB Saunders, Philadelphia, pp 307–318

    Google Scholar 

  3. Kirkpatrick ID, Kroeker MA, Greenberg HM (2003) Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia: initial experience. Radiology 229:91–98

    Article  PubMed  Google Scholar 

  4. Edwards MS, Cherr GS, Craven TE et al (2003) Acute mesenteric ischemia: surgical management and outcomes. Ann Vasc Surg 17:72–79

    Article  PubMed  Google Scholar 

  5. Shih MC, Hagspiel KD (2007) CTA and MRA in mesenteric ischemia: part 1, role in diagnosis and differential diagnosis. AJR 188:452–461

    Article  PubMed  Google Scholar 

  6. Bassiouny HS (1997) Nonocclusive mesenteric ischemia. In: Schwartz LB, Gewertz BL (eds) The surgical clinics of North America - mesenteric ischemia, 1st edn. WB Saunders, Philadelphia, pp 319–326

    Google Scholar 

  7. Trompeter M, Brazda T, Remy CT, Vestring T, Riemer P (2002) Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy. Eur Radiol 12:1179–1187

    Article  PubMed  Google Scholar 

  8. Acosta S, Ogren M, Sternby NH, Bergqvist D, Bjorck M (2006) Fatal nonocclusive mesenteric ischemia: population-based incidence and risk factors. J Intern Med 259:305–313

    Article  PubMed  CAS  Google Scholar 

  9. Horton KM, Fishman EK (2002) Volume-rendered 3D CT of the mesenteric vasculature: normal anatomic variants and pathologic conditions. Radiographics 22:161–172

    PubMed  Google Scholar 

  10. Horton KM, Fishman EK (2001) Multi-detector row CT of mesenteric ischemia: can it be done? Radiographics 21:1463–1473

    PubMed  CAS  Google Scholar 

  11. Lee R, Tung HKS, Tung PHM, Cheung SCW, Chan FL (2003) CT in acute mesenteric ischemia. Clin Radiol 58:279–287

    Article  PubMed  Google Scholar 

  12. Hellinger JC (2004) Evaluating mesenteric ischemia with multidetector - row CT angiography. Tech Vasc Interv Radiol 7(3):160–166

    Article  PubMed  Google Scholar 

  13. Fleischmann D (2003) Multiple detector-row CT angiography of the renal and mesenteric vessels. Eur J Radiol 45(Suppl 1):S79–S87

    Article  PubMed  Google Scholar 

  14. Sheedy SP, Earnest F, Fletcher JG, Fidler JL, Hoskin TL (2006) CT of small-bowel ischemia associated with obstruction in emergency department patients: diagnostic performance evaluation. Radiology 241(3):729–736

    Article  PubMed  Google Scholar 

  15. Acosta S, Ogren M, Sternby NH, Bergqvist D, Bjorck M (2005) Clinical implications for the management of acute thromboembolic occlusion of the superior mesenteric artery, autopsy findings in 213 patients. Ann Surg 241:516–522

    Article  PubMed  Google Scholar 

  16. Brenner DJ, Hall EJ (2007) Computed tomography-an increasing source of radiation exposure. N Engl J Med 357(22):2277–2284 Nov 29

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amos Ofer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ofer, A., Abadi, S., Nitecki, S. et al. Multidetector CT angiography in the evaluation of acute mesenteric ischemia. Eur Radiol 19, 24–30 (2009). https://doi.org/10.1007/s00330-008-1124-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-008-1124-5

Keywords

Navigation