title: The role of CT in predicting the need for surgery in patients diagnosed with mesenteric phlebosclerosis.
abstract: To determine if imaging findings on computed tomography (CT) can predict the need of surgery in patients with idiopathic mesenteric phlebosclerosis (IMP).This retrospective study included 28 patients with IMP. Abdominal CT images were reviewed to determine the extent and severity of mesenteric calcifications and the presence of findings related to colitides. We compared the number of colonic segments with mesenteric venous calcification, a total calcification score, and the rate of colonic wall thickening, pericolic fat stranding, and bowel loop dilatation between patients undergoing surgery (surgery group) and patients without surgery (nonsurgery group). Comparisons were made using the Mann-Whitney U test and Fisher exact test. Receiver operating characteristic analysis was also performed. Inter-reader agreement for the calcification scores was analyzed using kappa statistics.The number of colonic segments with mesenteric venous calcification and the total calcification scores were both significantly higher in the surgery group than the nonsurgery group (4.33 vs 2.96, P = 0.003; and 15.00 vs 8.96, P <0.001). The areas under the receiver operating characteristics to identify patients who need surgery were 0.96 and 0.92, respectively. The prevalence of bowel loop dilatation in the surgery group was also significantly higher than that in the nonsurgery group (16% vs 100%, P = 0.011).Evaluation of the severity and extent of IMP based on the total mesenteric venous calcification score, number of involved colonic segments, and the presence bowel loop dilatation on CT may be useful to indicate the outcomes of conservative treatment and need for surgery.
authors.affiliation: Department of Radiology, China Medical University Hospital School of Medicine Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University, Taichung E-Da Hospital and I-Shou University, Kaohsiung, Taiwan Center for Functional Onco-Imaging, School of Medicine, University of California, Irvine Departments of Radiology and Biomedical Imaging, and Urology, University of California, San Francisco, CA Division of Pediatric Pulmonology, China Medical University Children's Hospital Asia University, Taichung, Taiwan.
authors.forename: Wei-Ching
authors.initials: WC
authors.lastname: Lin
authors.forename: Jeon-Hor
authors.initials: JH
authors.lastname: Chen
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Westphalen
authors.forename: Chun-Han
authors.initials: CH
authors.lastname: Liao
authors.forename: Cheng-Hong
authors.initials: CH
authors.lastname: Chen
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Chen
authors.forename: Chien-Heng
authors.initials: CH
authors.lastname: Lin
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D065666:Mesenteric Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008642:Mesenteric Veins / Q000000981:diagnostic imaging*; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010690:Phlebography / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D061205:Vascular Calcification / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014656:Vascular Surgical Procedures