Comparison of Multiphasic Ct Scan of Abdomen in Patients of Mesenteric Ischaemia With Surgical Findings or Clinical Followup

Abstract

BACKGROUNDAcute and chronic mesenteric ischaemia remains a complex disease entity characterised by perfusion abnormality to the GI tract as it presents with nonspecific symptoms. MDCT offers high spatial resolution, fast scan times, 3D data sets, and excellent evaluation of nonvascular findings. Multiphasic CT scan features of acute bowel ischaemia will depend on its cause, location, extent and severity. Wide ranges of findings are seen in patients with mesenteric ischaemia. In fact, CT has demonstrated very high sensitivity and specificity for the diagnosis of mesenteric ischaemia and has replaced catheter angiography as the primary imaging modality of choice. MATERIALS AND METHODSWe have retrospectively reviewed 37 cases of mesenteric ischaemia which were diagnosed by MDCT scan during 27 months and were further sent for surgery and or DSA and clinical followup. These patients were further grouped to acute and chronic depending on stenosis/status of mesenteric vessels, bowel wall changes and collateral pathways, and CT findings were correlated with surgical/DSA findings/followup. RESULTSCommon findings of acute mesenteric ischaemia are Bowel wall thickening (80 %), Bowel distention (53.3 %) and altered bowel wall enhancement (46.6%), while other findings SMA dissection, Pneumatosis and Pneumoporta were 33.3%. Common findings of chronic mesenteric ischaemia are blocked SMA and collaterals filling post-block SMA (100%), stenosis of superior mesenteric artery (77.3%), stenosis of IMA (54.5%), and stenosis of celiac trunk (31.8%). CONCLUSIONMultiphasic MDCT in mesenteric ischaemia offers excellent evaluation of vascular structures, bowel wall and demonstrates possible primary cause of mesenteric ischaemia.

Assessment of cases of mesenteric ischaemia- A MDCT study

“…In this study, out of 32 patients, 18 lesions were acute which comprised of 10 males and 8 females and in 14 chronic lesions, 8 males and 6 females. Nagar et al [6] in their study retrospectively reviewed 37 cases of mesenteric ischaemia which were diagnosed by MDCT scan during 27 months and were further sent for surgery and or DSA and clinical follow up. These patients were further grouped to acute and chronic depending on stenosis/status of mesenteric vessels, bowel wall changes and collateral pathways, and CT findings were correlated with surgical/DSA findings/follow up.…”