Usefulness of computed tomography in differentiating transmural infarction from nontransmural ischemia of the small intestine in patients with acute mesenteric venous thrombosis.
OBJECTIVE
To determine computed tomographic findings that are helpful in differentiating transmural infarction from nontransmural ischemia in patients with mesenteric ischemia secondary to acute mesenteric venous thrombosis (MVT).


METHODS
Twenty-seven patients with symptomatic acute MVT were categorized into 2 groups: a transmural infarction (n = 13) and a nontransmural ischemia group (n = 14) based on findings at surgery and clinical follow-up. Computed tomographic scans were retrospectively reviewed by the consensus of 2 radiologists. Computed tomographic findings were compared between the 2 groups using the Fisher exact and the independent sample t test. Multifactorial logistic regression analysis was performed to determine the best predictors for differentiating transmural infarction from nontransmural ischemia.


RESULTS
Bowel segments with homogeneous enhancement (P = 0.001), decreased enhancement (P = 0.001), and indistinct outer margins (P = 0.006) were significantly more common in the transmural infarction group than in the nontransmural ischemia group. The differences in maximal lumen diameter (P = 0.027), extent of mesenteric haziness (P = 0.018), and amount of ascites (P = 0.035) were significant between the 2 groups. On multifactorial logistic regression analysis, decreased enhancement (P = 0.007) and maximal lumen diameter (P = 0.039) were independent significant variables in differentiating transmural infarction from nontransmural ischemia.


CONCLUSIONS
In patients with acute MVT, computed tomography is valuable in differentiating transmural infarction from nontransmural ischemia.
Lee
Seung Soo
SS
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Ha
Hyun Kwon
HK
Park
Seong Ho
SH
Choi
Eugene K
EK
Kim
Ah Young
AY
Kim
Jin Cheon
JC
Han
Duck Jong
DJ
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging*; D007421:Intestine, Small / Q000098:blood supply*; D007511:Ischemia / Q000000981:diagnostic imaging*; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging*; D008642:Mesenteric Veins; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*