[MDCT features of visceral vessel occlusion and malperfusion of the parenchyma in abdominal organs].
OBJECTIVE
The purpose of our study was to describe CT features of aortic branch vessel occlusion and abdominal malperfusion in patients with aortic dissection (AD).


METHODS
Between 01.2005 and 05.2008 in Hospital "St. Ekaterina" 153 patients with aortic dissection underwent multidetector CT. We retrospectively included in present study 95 patients with type I and III AD, with involvement of the abdominal aorta. We analyzed abdominal CT vessel and parenchymal abnormalities, including the presence of dissected abdominal aortic branches, a compressed aortic lumen, and low enhancement of the parenchyma in abdominal organs. Clinical features, methods of treatments, and in-hospital mortality was analyzed.


RESULTS
Clinical signs of malperfusion occurred in 39 (41%) of 95 patients presenting with AD. Iliofemoral malperfusion was the most common occurred ischemic syndrome and was observed in 31 cases, followed by renal--in 19 cases and mesenterial ischemia--in 12 cases. Spinal ischemia was the most rare--5 cases. In-hospital mortality was 38.5% in patients presenting with any malperfusion syndrome, as in 7 of them we observed aortic rupture, before initial treatment. Post-treatment mortality was 20.5%. 16% was the mortality rate among patiens without ischemia.


CONCLUSIONS
Early and precise diagnosis of ischemic abdominal and peripheral complications in patients with AD is the main goal of contemporary medicine. Multislice Computed Tomography is valuable imaging method in the evaluation of patient with AD, providing important information about aortic visceral branches and abdominal organs.
M
M
Nedevska
U
U
Dzhorgova
G
G
Nachev
D000005:Abdomen / Q000098:blood supply*; D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D011860:Radiography, Abdominal; D012039:Regional Blood Flow; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed