title: A scoring system for the assessment of angiographic findings in non-occlusive mesenteric ischemia (NOMI).
abstract: OBJECTIVE
  To establish a standardized scoring system for angiographic findings in patients with non-occlusive mesenteric ischemia (NOMI).
  
  
  METHODS
  In 36 patients (mean age: 72 years), 53 angiographies of the superior mesenteric artery (SMA) were performed for suspected NOMI after cardiac or major aortic surgery. All examinations were performed using a standardized DSA technique. Two experienced radiologists performed a consensus reading blinded to the clinical information, on two occasions with an interval of two weeks. In order to investigate the reproducibility of the criteria, the images were assessed once by an intensivist and a medical student. Image analysis was performed with respect to vessel morphology, reflux of contrast medium into the aorta, small bowel parenchymal contrast enhancement and distension and the delay between arterial injection and portal vein filling.
  
  
  RESULTS
  Almost perfect intra-observer correlation was obtained for the assessment of the contrast medium reflux (κ = 0.82) and substantial correlation for the time of portal vein filling (κ = 0.66). Moderate correlations were obtained for the vessel morphology (κ = 0.51), small bowel enhancement (κ = 0.63) and distension (κ = 0.53). Contrast medium reflux into the aorta (κ = 0.77 and 0.63) and the time of portal vein filling (κ = 0.42 and 0.58) resulted in the highest inter-observer correlations between the radiologists and the intensivist as well as the radiologists and the student.
  
  
  CONCLUSIONS
  In patients with suspected NOMI, using our scoring system yields high intra- and inter-observer correlations, allowing a standardized evaluation of angiographic findings.
authors.affiliation: Diagnostic and Interventional Radiology, Saarland University Hospital. peterminko@yahoo.com
authors.forename: P
authors.initials: P
authors.lastname: Minko
authors.forename: H
authors.initials: H
authors.lastname: Groesdonk
authors.forename: J
authors.initials: J
authors.lastname: Stroeder
authors.forename: J
authors.initials: J
authors.lastname: Miodek
authors.forename: S
authors.initials: S
authors.lastname: Graeber
authors.forename: A
authors.initials: A
authors.lastname: Bücker
authors.forename: H J
authors.initials: HJ
authors.lastname: Schäfers
authors.forename: M
authors.initials: M
authors.lastname: Katoh
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging*; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging*; D065666:Mesenteric Ischemia; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014652:Vascular Diseases / Q000000981:diagnostic imaging*