title: Usefulness of computed tomography in differentiating transmural infarction from nontransmural ischemia of the small intestine in patients with acute mesenteric venous thrombosis.
abstract: 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.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Seung Soo
authors.initials: SS
authors.lastname: Lee
authors.forename: Hyun Kwon
authors.initials: HK
authors.lastname: Ha
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Park
authors.forename: Eugene K
authors.initials: EK
authors.lastname: Choi
authors.forename: Ah Young
authors.initials: AY
authors.lastname: Kim
authors.forename: Jin Cheon
authors.initials: JC
authors.lastname: Kim
authors.forename: Duck Jong
authors.initials: DJ
authors.lastname: Han
mesh_terms: 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*