Assessment of patients with acute mesenteric ischemia: multislice computed tomography signs and clinical performance in a group of patients with surgical correlation.

AIM

The aim of this paper was to describe signs and performance of multislice computed tomography (MSCT) in patients with acute mesenteric infarction (AMI).

METHODS

MSCT examinations of 26 patients with AMI and of 34 patients with acute abdomen and surgical diagnosis excluding AMI were retrospectively analyzed. All studies were performed with arterial and portal venous phase scans, 2.5 mm thickness, 1.25 mm image interval. All abnormal findings at MSCT in patients with AMI were recor- ded. Patients with MSCT evidence of mesenteric artery occlusion or pneumatosis or venous gas or, alternatively, bowel thicken-ing associated with lack of wall enhancement or venous thrombosis or parenchimal infarction were considered to be affected by AMI.

RESULTS

AMI was due to mesenteric artery thrombosis in 17 patients, mesenteric vein thrombosis in 7, and nonocclusive ischemia in 2. In 16/17 patients arterial thrombosis was visualized, in 7/7 venous thrombosis was found. Portal or mesenteric vein gas was seen in 5% and pneumatosis in 38%; bowel wall thickening associated with other signs was found in 31%. Sensitivity and specificity were 92% and 100%, respectively.

CONCLUSIONS

MSCT allows an accurate assessment of the mesenteric circulation and the bowel wall. This makes possible optimal visualization of signs of AMI resulting in a good clinical performance.