Acute mesenteric ischemia: diagnosis with contrast-enhanced CT.
OBJECTIVE
To evaluate the accuracy of dynamic, contrast material-enhanced computed tomography (CT) in the diagnosis of acute mesenteric ischemia.


METHODS
Reviewers blinded to patient diagnoses retrospectively compared the CT scans in a study group with those in a control group. The study group comprised 39 consecutive patients (23 men, 16 women; aged 55-88 years) with surgically proved acute mesenteric ischemia. The control group comprised 24 patients (13 men, 11 women; aged 50-82 years) with suspected acute mesenteric ischemia that was disproved at surgery.


RESULTS
For the diagnosis of acute mesenteric ischemia, each of the following findings had a specificity of more than 95% and a sensitivity of less than 30%: arterial or venous thrombosis, intramural gas, portal venous gas, focal lack of bowel-wall enhancement, and liver or splenic infarcts. When CT was used in the diagnosis of suspected acute mesenteric ischemia, the detection of at least one of these signs resulted in a sensitivity of 64% (25 of 39; confidence interval, 0.49, 0.79), a specificity of 92% (22 of 24; confidence interval, 0.81, 1.00), and an accuracy of 75% (47 of 63; confidence interval, 0.64, 0.86).


CONCLUSIONS
Dynamic, contrast-enhanced CT is a valuable tool in the diagnosis of and determination of prognosis in acute mesenteric ischemia.
Taourel
P G
PG
Department of Medical Imaging, Hôpital Saint-Eloi, Montpellier, France.
Deneuville
M
M
Pradel
J A
JA
Régent
D
D
Bruel
J M
JM
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003287:Contrast Media; D005260:Female; D006801:Humans; D007483:Iothalamic Acid / Q000031:analogs & derivatives*; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008643:Mesentery / Q000098:blood supply*; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data
D003287:Contrast Media; D007483:Iothalamic Acid; C002587:ioxitalamic acid