Multidetector CT angiography in the evaluation of acute mesenteric ischemia |
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Authors: | Amos Ofer Sobhi Abadi Samy Nitecki Tony Karram Igor Kogan Maxim Leiderman Pavel Shmulevsky Shlomi Israelit Ahuva Engel |
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Institution: | (1) Rambam Medical Center, Halyia 8, Haifa, 31096, Israel;(2) Vascular Surgery, Rambam Medical Center, Halyia 8, Haifa, 31096, Israel;(3) Surgery B, Rambam Medical Center, Halyia 8, Haifa, 31096, Israel;(4) Surgery C, Rambam Medical Center, Halyia 8, Haifa, 31096, Israel |
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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. |
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Keywords: | Acute mesenteric ischemia CT angiography Multidetector CT |
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