title: CT angiography in the setting of suspected acute mesenteric ischemia: prevalence of ischemic and alternative diagnoses.
abstract: The purpose of the study was to determine the prevalence of ischemic and alternative diagnoses and the diagnostic accuracy of CT angiography (CTA) in the setting of suspected acute mesenteric ischemia (AMI).
  
  
  
  We included 959 patients undergoing CTA for the evaluation of suspected AMI. The final clinical diagnosis was used to determine the prevalence of ischemic and alternative diagnoses and to calculate the diagnostic accuracy of CTA. Prevalence of diagnoses by age, sex, and admission status was compared using Cochran-Armitage and χ2tests.
  
  
  
  Prevalence was 18.8% (180/959) for AMI and 61.2% (587/959) for specific alternative diagnoses. In the remaining 20.0% (192/959), no clear clinical diagnosis was established. The most frequent alternative diagnoses were small-bowel obstruction (10.4%; 61/587), infectious colitis (8.7%; 51/587), pneumonia (6.5%; 38/587), cholecystitis (6.1%; 36/587), and diverticulitis (5.6%; 33/587). Prevalence of specific alternative diagnoses varied significantly according to both age (p < .013) and admissions status (p < 0.001). CTA had a sensitivity and specificity for diagnosing AMI of 89.4%/99.5% and for alternative diagnoses of 86.7%/96.9%, respectively.
  
  
  
  In the setting of suspected AMI, the prevalence of ischemic and alternative diagnoses varies significantly by age, sex, and admission status. CTA provides for rapid and non-invasive assessment of ischemic and alternative diagnoses with high diagnostic accuracy.
authors.affiliation: Department of Radiology, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. fhenes@uke.de.
authors.forename: Frank Oliver
authors.initials: FO
authors.lastname: Henes
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA.
authors.forename: Perry J
authors.initials: PJ
authors.lastname: Pickhardt
authors.affiliation: Department of Radiology, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Herzyk
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA.
authors.forename: Utaroh
authors.initials: U
authors.lastname: Motosugi
authors.affiliation: Department of Radiology, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Derlin
authors.affiliation: Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA.
authors.forename: Meghan G
authors.initials: MG
authors.lastname: Lubner
authors.affiliation: Department of Radiology, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Adam
authors.affiliation: Department of Medical Biometry and Epidemiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schön
authors.affiliation: Department of Radiology, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.|Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Bannas
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000072226:Computed Tomography Angiography / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D065666:Mesenteric Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: Acute mesenteric ischemia; Alternative diagnosis; Bowl ischemia; Computed tomography angiography; Multidetector CT