Imaging findings and management of isolated dissection of the visceral arteries.
OBJECTIVE
To describe clinical and computed tomography (CT) findings of isolated dissection of the visceral arteries (IDVA).


METHODS
We retrospectively analyzed clinical presentation and abdominal CT findings of 38 patients who were diagnosed as having an IDVA. IDVA were classified into three types based on CT findings: patent false lumen with re-entry (type I), patent false lumen without re-entry (type II), and completely thrombosed false lumen (type III).


RESULTS
The dissection was located in the superior mesenteric artery (SMA) in 27 patients, celiac artery (CA) in 6, CA to splenic artery in 2, and common hepatic artery (CHA), CA to CHA, and inferior mesenteric artery (IMA) in 1 patient each. The dissection was classified into type I in 8 patients, type II in 12, and type III in 18. Surgical treatment was performed in 1 patient with type II SMA dissection because of bowel ischemia, although the remaining 37 patients were managed conservatively. Two cases with type II showed a progressive enlargement of the false lumen in follow-up CT. Increased density of the fat tissue around the affected visceral artery was more commonly seen in symptomatic patients compared to asymptomatic ones (P < 0.01).


CONCLUSIONS
Based on our observation, patients with IDVA can be managed conservatively when there are no signs indicating organ ischemia.
Tokue
Hiroyuki
H
Department of Diagnostic and Interventional Radiology, Gunma University Hospital, Maebashi, Japan. tokue@s2.dion.ne.jp
Tsushima
Yoshito
Y
Endo
Keigo
K
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D002445:Celiac Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging* / Q000601:surgery; D017537:Mesenteric Artery, Inferior / Q000000981:diagnostic imaging; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013157:Splenic Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D003287:Contrast Media