Value of multislice computed tomography in the diagnosis of acute mesenteric ischemia.
OBJECTIVE
To define the value of multislice computed tomography (CT) in the diagnosis of acute mesenteric ischemia (AMI).


METHODS
Two hundred patients (age range: 20-92 years) who were referred to the emergency CT department with a clinical suspicion of AMI were prospectively included in the study. CT examinations were performed with a multislice (16) CT scanner and the protocol included pre-contrast, arterial and venous phase acquisitions. Images were evaluated by using multiplanar reconstruction, maximum intensity projection and volume-rendering techniques at the CT workstation.


RESULTS
Ninety-four patients (47%) underwent surgery for AMI or for other causes of acute abdominal pain. One hundred-six patients (53%) were followed conservatively according to clinical, radiologic and laboratory findings. Of the 94 patients who underwent surgery, 49 (25%) were found to have AMI. All of these 49 patients with a proven AMI diagnosis were diagnosed with CT. In the other 45 patients who underwent surgery, CT findings were negative for AMI. None of the patients, who were followed conservatively, were eventually diagnosed as having AMI except 1 patient. This patient was unfit for surgery although his clinical and radiologic findings were consistent with AMI and died in 3 days. The sensitivity and specificity values of CT for the detection of AMI were calculated to be 100% for each.


CONCLUSIONS
Multislice CT is an effective imaging technique for the diagnosis of AMI with excellent sensitivity and specificity values.
Yikilmaz
Ali
A
Erciyes University, School of Medicine, Gevher Nesibe Hospital, Department of Radiology, Talas Yolu, 38038 Melikgazi, Kayseri, Turkey. dryikilmaz@yahoo.com
Karahan
Okkes Ibrahim
OI
Senol
Serkan
S
Tuna
Ibrahim Sacit
IS
Akyildiz
Hizir Yakup
HY
D000006:Abdomen, Acute / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D016009:Chi-Square Distribution; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D065666:Mesenteric Ischemia; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000473:pathology
D003287:Contrast Media