title: Usefulness of multidetector-row CT (MDCT) for the diagnosis of non-occlusive mesenteric ischemia (NOMI): assessment of morphology and diameter of the superior mesenteric artery (SMA) on multi-planar reconstructed (MPR) images.
abstract: OBJECTIVE
  The purpose of this study was to assess the efficacy of multidetector-row CT (MDCT) for the diagnosis of non-occlusive mesenteric ischemia (NOMI) by analyzing morphology and diameter of superior mesenteric artery (SMA). We assessed whether MDCT was as useful as angiography for the diagnosis of NOMI.
  
  
  METHODS
  Four patients who were diagnosed with NOMI were retrospectively analyzed. All patients had 8-row MDCT followed by laparotomy. Two of them underwent angiography after MDCT. The morphology and diameter of SMA of these cases was analyzed on multi-planar reconstructed (MPR) images. The mean diameter of SMA of NOMI cases was compared to that of 13 control cases.
  
  
  RESULTS
  MPR images of all NOMI cases showed irregular narrowing of the SMA, spasm of the arcades of SMA, and poor demonstration of intramural vessels. MPR images of two patients who had angiography were concordant with their angiograms. The mean diameter of SMA of NOMI patients was 3.4±1.1mm, which was statistically smaller than that of 13 control patients, 6.0±1.5mm (P<0.05, Wilcoxon rank sum tests).
  
  
  CONCLUSIONS
  Angiography has been recognized essential for the diagnosis of NOMI. This study shows the possibility of MDCT to be an equivalently useful modality compared to angiography for the diagnosis of NOMI by interpreting morphologic appearance and diameter of SMA. Introduction of MDCT in the decision tree of NOMI treatment may bring the benefit of prompt diagnosis and subsequent early and efficient initiation of therapy, which may improve the mortality.
authors.affiliation: Department of Radiology, Kitasato University School of Medicine, Kitasato, Sagamihara, Kanagawa, Japan. reikow@hotmail.co.jp
authors.forename: Reiko
authors.initials: R
authors.lastname: Woodhams
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishimaki
authors.forename: Kaoru
authors.initials: K
authors.lastname: Fujii
authors.forename: Satoko
authors.initials: S
authors.lastname: Kakita
authors.forename: Kazushige
authors.initials: K
authors.lastname: Hayakawa
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D016022:Case-Control Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D017538:Mesenteric Artery, Superior; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media