J Korean Radiol Soc.  2005 Sep;53(3):185-190. 10.3348/jkrs.2005.53.3.185.

Assessment of Mesenteric Vascular Steno-occlusive Lesion in Acute Mesenteric Ischemia: Comparison between CT Angiography and Digital Subtraction Angiography

• Shin SS
• Jeong YY
• Shen YL
• Yoon W
• Lim HS
• Song SG
• Jang NK
• Kim JK
• Kang HK

• KMID: 2302571
• DOI: http://doi.org/10.3348/jkrs.2005.53.3.185

Abstract

PURPOSE
Acute mesenteric ischemia (AMI) is one of the most dramatic abdominal emergencies. The most common cause of AMI is a thrombo-embolism of the mesenteric artery or vein. The aim of this study was to evaluate the feasibility of CT angiography for evaluating mesenteric vascular steno-occlusive lesion in AMI.
MATERIALS AND METHODS
Fifteen patients with clinically and angiographically proven AMI underwent a two-phase CT. The CT angiographic images were reconstructed using a 3D rendering algorithm, such as the maximum intensity projection and volume-rendering. All the CT angiographic images were reviewed with respect to stenosis or occlusion of mesenteric vessel by the consensus of two radiologists, and were correlated with the findings of digital subtraction angiography.
RESULTS
Digital subtraction angiography (DSA) visualized 60 mesenteric vessels including the superior mesenteric artery (n=15) and vein (n=15), and the inferior mesenteric artery (n=15) and vein (n=15). DSA showed steno-occlusive lesions in 16 mesenteric vessels (13 superior mesenteric arteries, two superior mesenteric veins, and one inferior mesenteric artery). CT angiography detected steno-occlusive lesions in 16 mesenteric vessels (12 superior mesenteric arteries, one superior mesenteric vein, and three inferior mesenteric arteries). The sensitivity, specificity, and accuracy of CT angiography for evaluating mesenteric vascular steno-occlusive lesion were 87.5%, 95.4%, and 93.3%, respectively.
CONCLUSION
CT angiography is an useful adjunct to abdominal CT in an AMI setting on account of its ability to detect the causes of AMI such as a steno-occlusive lesion of the mesenteric vessel.

Keyword

Abdomen, acute conditions; Abdomen, CT; Mesentery, ischemia

MeSH Terms

Angiography*
Angiography, Digital Subtraction*
Consensus
Constriction, Pathologic
Emergencies
Humans
Ischemia*
Mesenteric Arteries
Mesenteric Artery, Inferior
Mesenteric Artery, Superior
Mesenteric Veins
Sensitivity and Specificity
Tomography, X-Ray Computed
Veins