title: Role of multidetector CT angiography in the evaluation of suspected mesenteric ischemia.
abstract: OBJECTIVE
  To assess the role of multidetector CT angiography (MDCTA) in the diagnosis of acute mesenteric ischemia (AMI) and to compare the diagnostic utility of axial images with reconstructed images.
  
  
  METHODS
  In this Institute Review Board approved prospective study, MDCTA was performed on 31 patients who presented with the clinical suspicion of AMI (25M; 6F, age range: 16-73 years). Axial and reconstructed images of each patient were evaluated independently by two radiologists for evidence of bowel wall thickening, abnormal mucosal enhancement, bowel dilatation or obstruction, mesenteric stranding, ascites, solid organ infarcts, pneumatosis intestinalis or porto-mesenteric gas, and mesenteric arterial or venous occlusion. MDCT findings were correlated with the surgical findings and clinical outcome. Patients were later divided into two groups: a study group of patients with proven AMI and a control group of patients with an alternate diagnosis, for the purpose of statistical analysis.
  
  
  RESULTS
  AMI was correctly diagnosed in all 16 patients on MDCTA (100% sensitivity and specificity) of whom nine patients underwent surgical exploration. Three patients expired before surgery and the remaining 5 patients were proven based on positive clinical and laboratory findings. Mesenteric arterial occlusion was seen in 7 patients while 5 patients had portomesenteric venous thrombosis. Reconstructed images using minimum intensity projection, volume rendering and multiplanar volume reconstruction were found to perform better for the detection of vascular abnormalities and improved the diagnostic confidence of both radiologists in the evaluation of bowel and mesenteric abnormalities.
  
  
  CONCLUSIONS
  MDCTA is an effective non-invasive modality for the diagnosis of mesenteric ischemia.
authors: Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors: Meghna
authors: M
authors: Barmase
authors: Mandeep
authors: M
authors: Kang
authors: Jaidev
authors: J
authors: Wig
authors: Rakesh
authors: R
authors: Kochhar
authors: Rajesh
authors: R
authors: Gupta
authors: Niranjan
authors: N
authors: Khandelwal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging*; D008297:Male; D008643:Mesentery / Q000098:blood supply*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult