Evaluation of acute mesenteric ischemia: accuracy of biphasic mesenteric multi-detector CT angiography |
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Authors: | A J Aschoff G Stuber B W Becker M H K Hoffmann B L Schmitz H Schelzig T Jaeckle |
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Institution: | Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Ulm, Germany. andrik.aschoff@uni-ulm.de |
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Abstract: | The purpose of this study was to explore the accuracy of multi-detector row helical CT (MDCT), using a biphasic mesenteric
angiography protocol for evaluation of acute mesenteric ischemia (AMI). In total, 79 consecutive patients with clinical signs
of AMI underwent contrast enhanced 16- or 40-channel MDCT. MDCT findings were correlated with surgery, endoscopy and clinical
outcome. Sensitivity, specificity, and positive and negative predictive values were calculated using the patients in which
AMI had been excluded as a control group. In 28 patients the final diagnosis was AMI. In 27 patients (96.4%) MDCT correctly
diagnosed AMI (specificity of 97.9%). A sensitivity of 93%, specificity of 100%, and positive and negative predictive values
of 100% and 94%, respectively were achieved for the CT findings of visceral artery occlusion, intestinal pneumatosis, portomesenteric
venous gas or bowel wall thickening in combination with either portomesenteric thrombosis or solid organ infarction. Our findings
suggest that mesenteric MDCT angiography is an accurate tool for fast diagnostic work-up of patients with suspected AMI. |
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Keywords: | Mesenteric ischemia Multi-detector-row computed tomography Diagnosis |
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