title: Spontaneous dissection of the splanchnic arteries: CT findings, treatment, and outcome.
abstract: OBJECTIVE
  The purpose of this study was to describe the various CT findings of isolated spontaneous splanchnic artery dissection and the treatment options and outcomes.
  
  
  METHODS
  From January 1999 to May 2008, splanchnic artery dissection was diagnosed through CT angiography in 34 patients (28 men, six women) without recent trauma or aortic disease. All patients were classified as having either symptomatic (n = 19) or asymptomatic (n = 15) dissection. We analyzed imaging findings of intimal flap, aneurysmal dilatation, thrombosed false lumen, periarterial fatty infiltration, branch vessel involvement, bowel ischemic signs, and the extent of involvement of each artery with each treatment method and the outcomes.
  
  
  RESULTS
  Intimal flap (n = 37 [88.1%]; symptomatic, 22; asymptomatic, 15), thrombosed false lumen (n = 27 [64.3%]; symptomatic, 19; asymptomatic, 8), and aneurysmal dilatation (n = 22 [52.4%]; symptomatic, 14; asymptomatic, 8) were seen. Periarterial fatty infiltration and branch vessel involvement differed between the symptomatic and asymptomatic groups (p < 0.01). Renal artery dissection was found in six patients (symptomatic, 3; asymptomatic, 3). Six patients were lost to follow-up. Treatments included conservative management without anticoagulation therapy (n = 19; symptomatic, 8; asymptomatic, 11), endovascular stent insertions (n = 6; symptomatic, 6; asymptomatic, 0), and surgery (n = 3; symptomatic, 3; asymptomatic, 0). Patients with a follow-up interval of more than 10 days had disease in a stationary state (n = 14; symptomatic, 4; asymptomatic, 10), were in improved condition (n = 12; symptomatic, 11; asymptomatic, 1), or had progression of disease (n = 2; symptomatic, 2; asymptomatic, 0).
  
  
  CONCLUSIONS
  Intimal flap, thrombosed false lumen, and aneurysmal dilatation are the most common CT findings of spontaneous splanchnic artery dissection. In splanchnic artery dissection, conservative management without anticoagulation had good outcome except in patients with bowel ischemia, aneurysmal dilatation three times larger than a normal segment, or progression of dissection.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.
authors.forename: Seung Chai
authors.initials: SC
authors.lastname: Jung
authors.forename: Whal
authors.initials: W
authors.lastname: Lee
authors.forename: Eun-Ah
authors.initials: EA
authors.lastname: Park
authors.forename: Hwan Jun
authors.initials: HJ
authors.lastname: Jae
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Chung
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000628:therapy; D002445:Celiac Artery / Q000000981:diagnostic imaging*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging*; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging; D013152:Splanchnic Circulation; D015607:Stents; D014057:Tomography, X-Ray Computed