Diagnostic imaging of mesenteric infarction.

Klein, Hans-Martin; Lensing, Rutger J.; Klosterhalfen, B.; Töns, C.; Rw, Günther

doi:10.1148/radiology.197.1.7568858

Cited by 151 publications

(69 citation statements)

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“…[7] However, difficulties in clinical practice and the invasive nature of the DSA procedure are difficult to manage in emergency situations. This procedure is now being replaced by thin-slice computed tomography (CT) and CT-aided angiography.…”

Section: Discussionmentioning

confidence: 99%

Role Of Alkaline Phosphatase Intestine-Isomerase In Acute Mesenteric Ischemia Diagnosis

Lapsekili¹,

Menteş

Balkan

et al. 2015

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

Role Of Alkaline Phosphatase Intestine-Isomerase In Acute Mesenteric Ischemia Diagnosis

Lapsekili¹,

Menteş

Balkan

et al. 2015

Ulus Travma Acil Cerrahi Derg

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“…1). As DSA allows only catheter based angiography and is thus limited to vascular diagnoses, all tested noninvasive modalities may provide additional information regarding tissue and organs surrounding the mesenteric arteries and thus expand the diagnostic field [6-8, [14][15][16][17]. Especially in patients with acute mesenteric ischemia, CTA is considered the first-line imaging method [16][17][18][19][20][21][22].…”

Section: Image Qualitymentioning

confidence: 99%

Comparison of Noninvasive Imaging Modalities for Stenosis Grading in Mesenteric Arteries

Schaefer

Pfarr

Trentmann

et al. 2013

Fortschr Röntgenstr

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Bildqualität wurde beurteilt mit 1-unzureichend, 2-schlecht, 3-mäßig, 4-gut oder 5-exzellent. Stenosen wurden eingeteilt in die Grade 1 (< 25 %), 2 (25 -< 50 %), 3 (50 -< 75 %) oder 4 (> 75 %). Mittels zweiseitigen Chi-Quadrat-Tests wurde die Korrelation in der Stenosegradbeurteilung zwischen den Modalitäten bestimmt. Mittels gewichtetem Cohen's-kappa wurde das Korrelationsmaß berechnet. Für nicht-relevante versus relevante Stenosen (Schwellenwert 50 %) wurden Sensitivität, Spezifität, PPV, NPV und Genauigkeit ermittelt. Ergebnisse: Die durchschnittliche Bildqualität für DSA/Duplex-Sonografie/CTA/MRA lag bei 3,8 ± 0,7/3,1 ± 1,0/4,4 ± 0,7/3,8 ± 0,9. Alle nicht-invasiven Modalitäten erreichten eine signifikante Korrelation in der Stenosegradbeurteilung für TC und AMS im Vergleich mit der DSA mit jeweils p < 0,001. Der gewichtete Cohen's-kappa betrug für Duplex-Sonografie/CTA/MRA für TC 0,94/ 0,93/0,74 und für AMS 0,64/ 0,91/ 0,56. Die höchste Sensitivität/Spezifität/NPV/PPV/Genauigkeit erreichte die CTA mit 100 %/95 %/85 %/ 100 %/96 % für den TC und mit na/98 %/na/100 %/ 98 % für die AMS. Schlussfolgerung: Bei bester Bildqualität erreichte die CTA das höchste Maß an Korrelation in der Stenosegradbeurteilung und bot die größte diagnostische Genauigkeit. Abstract !Objective: To prospectively analyze duplex sonography, CTA, and MRA with respect to stenosis grading of the celiac trunk (TC) and the superior mesenteric artery (SMA), with DSA as the reference. Materials and Methods: 52 subjects were enrolled (mean age: 71). The image quality was graded: 1-insufficient, 2-bad, 3-moderate, 4-good or 5-excellent. Stenosis was graded: 1 (< 25 %), 2 (25 -< 50 %), 3 (50 -75 %) or 4 (75 %). Two-sided chi-square tests were used to check for correlation of stenosis grading between modalities. The weighted Cohen's kappa was calculated to assess the strength of correlation. With a threshold of 50 % for non-relevant stenosis vs. relevant stenosis, the sensitivity, specificity, PPV, NPV, and accuracy were calculated. Results: The mean image quality was 3.8 ± 0.7, 3.1 ± 1.0, 4.4 ± 0.7, and 3.8 ± 0.9 for DSA, duplex sonography, CTA, and MRA, respectively. For both TC and SMA, stenosis grading reached a significant level of correlation between each noninvasive modality with DSA (p < 0.001, each). The weighted Cohen's kappa for duplex sonography/ CTA/MRA was 0.94/0.93/0.74, respectively, for the TC and 0.64/0.91/0.56, respectively, for the SMA. Highest sensitivity/specificity/NPV/PPV/ accuracy were found for CTA with 100 %/95 %/ 85 %/100 %/96 % for the TC and with na/98 %/na/ 100 %/98 %, respectively, for the SMA. Conclusion: CTA provided the best image quality, reached the highest level of agreement and significance in correlation in stenosis grading, and offered the best diagnostic accuracy.This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

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“…Ancak günümüzde anjiyografi, multidetektör BT teknolojisindeki gelişmeler nedeni ile daha çok seçilmiş vakalarda kullanılmaktadır. BT, AMİ tanısında önemli rol oynar ve duyarlılığı %94-96 oranında rapor edilmektedir (7,8). AMİ'de BT bulguları olarak; bağırsakta artmış duvar kalınlığı, pnömato-zis intestinalis, dilatasyon ve bağırsak duvarı kontrast madde tutulumunda azalma sayılabi-lir (9).…”

unclassified

Superior Mezenter Arter Embolisinde Erken Tanı ve Embolektomi

Aydın¹,

Yücel²,

Pergel³

et al. 2016

Kocatepe Tıp Dergisi

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ÖZAkut mezenter arter embolisi, acil girişim gerektiren, nekroz geliştiğinde yaygın ince barsak rezeksiyonu ve sonrasında gelişen kısa barsak sendromu nedeniyle yaşam kalitesini düşüren, morbidite ve mortalitesi oldukça yüksek bir hastalıktır. Multidetektör kontrastlı BT, akut mezenterik embolinin erken tanısında oldukça önemli-dir. Biz burada, kontrastlı abdominal BT ile erken tanı ve sonrasında bağırsak rezeksiyonu gerekmeden yalnızca embolektomi yaparak tedavi ettiğimiz olguyu sunmayı amaçladık.Anahtar Kelimeler: Akut mezenter arter embolisi, multidetektör abdominal BT, embolektomi ABSTRACTAcute mesenteric arterial is an emergent state that requires urgent intervention. If massive small bowel necrosis is evident not only the patient's quality of life can be worsened after short bowel syndrome due to massive small bowel resection but also it has high morbidity and mortality rate. Multidetector CT is a valuable tool for the evaluation of acute mesenteric arterial embolus. We present herein a case of acute mesenteric embolus which was detected with contrast-enhanced CT of the abdomen and treated with open embolectomy without resection of small bowel.

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Diagnostic imaging of mesenteric infarction.

Abstract: CT and angiography are highly sensitive, but CT can also be used to rule out other causes of acute abdomen. Careful evaluation of patient history and clinical situation should lead to suspicion of mesenteric ischemia and early indication for CT.

Cited by 151 publications

References 0 publications

Role Of Alkaline Phosphatase Intestine-Isomerase In Acute Mesenteric Ischemia Diagnosis

Role Of Alkaline Phosphatase Intestine-Isomerase In Acute Mesenteric Ischemia Diagnosis

Comparison of Noninvasive Imaging Modalities for Stenosis Grading in Mesenteric Arteries

Superior Mezenter Arter Embolisinde Erken Tanı ve Embolektomi

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