title: Acute mesenteric vein thrombosis: factors associated with evolution to chronic mesenteric vein thrombosis.
abstract: OBJECTIVE
  Acute mesenteric venous thrombosis signs at MDCT are well described, but the literature lacks studies assessing their evolution. We aimed to describe the radiologic evolution of isolated acute mesenteric venous thrombosis and associated prognostic factors.
  
  
  METHODS
  Patients with isolated acute mesenteric venous thrombosis with follow-up for a minimum of 1 month with MDCT were selected. Images at the acute phase and on follow-up were reviewed in consensus reading. For acute mesenteric venous thrombosis, we searched for low-attenuated intraluminal filling defect. For chronic mesenteric venous thrombosis, we searched for vessel stenosis or occlusion associated with collateral mesenteric veins. Treatment, thrombosis risk factor, symptoms, location, and length and diameter of mesenteric venous thrombosis were reported and correlated with evolution over time.
  
  
  RESULTS
  Twenty patients (nine women and 11 men; mean age, 52 years) were selected. Four patients recovered without radiologic sequelae, and 16 developed chronic mesenteric venous thrombosis signs. Anticoagulation did not influence recovery (p = 1). Patients with recovery compared with patients with chronic mesenteric venous thrombosis showed more frequent central lesions (p = 0.03). At diagnosis, the thrombosed segment was shorter and larger in the complete radiologic recovery group compared with the chronic mesenteric venous thrombosis signs group: mean length (± SD) 6.25 ± 3.21 cm and 12.81 ± 5.96 cm, respectively (p = 0.01); mean transverse diameter 1.82 ± 0.42 cm and 1.12 ± 0.34 cm, respectively (p = 0.01). Mesenteric fat infiltration at diagnosis was more frequent in the chronic mesenteric venous thrombosis signs group than in the complete recovery group (p = 0.03).
  
  
  CONCLUSIONS
  Most cases of acute mesenteric venous thrombosis evolve toward the chronic form with vein stenosis or occlusion and development of collateral veins. Location, length of mesenteric venous thrombosis, transverse diameter of the vein, and mesenteric fat infiltration at diagnosis are determinant factors for mesenteric venous thrombosis evolution.
authors.affiliation: 1 Department of Radiology and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
authors.forename: Naïk
authors.initials: N
authors.lastname: Vietti Violi
authors.forename: Nicolas
authors.initials: N
authors.lastname: Fournier
authors.forename: Rafael
authors.initials: R
authors.lastname: Duran
authors.forename: Sabine
authors.initials: S
authors.lastname: Schmidt
authors.forename: Pierre
authors.initials: P
authors.lastname: Bize
authors.forename: Boris
authors.initials: B
authors.lastname: Guiu
authors.forename: Alban
authors.initials: A
authors.lastname: Denys
mesh_terms: D000208:Acute Disease; D002908:Chronic Disease; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D008642:Mesenteric Veins; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011379:Prognosis; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: CT; mesenteric vein thrombosis; small bowel