Mesenteric artery calcium scoring: a potential screening method for chronic mesenteric ischemia

Terlouw, Luke G.; Noord, Désirée Leemreis van; Walsum, Theo van; Bruno, Marco J.; Moelker, Adriaan

doi:10.1007/s00330-020-07530-0

Cited by 3 publications

(7 citation statements)

References 26 publications

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“…Calcium scoring was performed from origin until bifurcation for CA and from origin until the first large jejunal artery for SMA. The MACS of CA + SMA was classified as low (<29.7), intermediate (29.7–422), or high (>422), based on the observed sensitivity and specificity in the original study 7 …”

Section: Methodsmentioning

confidence: 99%

“…The methods used to calculate the MACS have been described in detail. 7 In short, a custom build software module (MeVisLab version 2.7.1, MeVis Medical Solutions AG), using the Agatston definition, was developed and used to calculate the MACS of a CT for the CA and SMA. 11 Assumptions were made to standardize the areas of calcium scoring.…”

Section: Mesenteric Artery Calcium Scorementioning

confidence: 99%

“…The MACS of CA + SMA was classified as low (<29.7), intermediate (29.7-422), or high (>422), based on the observed sensitivity and specificity in the original study. 7 Validation of the score chart by van Dijk et al…”

Section: Mesenteric Artery Calcium Scorementioning

confidence: 99%

“…Early risk stratification based on standard CT imaging could facilitate the diagnostic trajectory, raise awareness, reduce diagnostic delays in CMI patients, and avoid an extensive and cumbersome diagnostic workup of CMI in patients without CMI. The mesenteric artery calcium score (MACS) is calculated on CT images by multiplying the volume of a calcified lesion with a density factor and has recently been reported to discriminate CMI patients from non‐CMI patients 7 . However, the MACS should be correlated with symptoms in order to be clinically applicable.…”

Section: Introductionmentioning

confidence: 99%

“…The mesenteric artery calcium score (MACS) is calculated on CT images by multiplying the volume of a calcified lesion with a density factor and has recently been reported to discriminate CMI patients from non-CMI patients. 7 However, the MACS should be correlated with symptoms in order to be clinically applicable. Risk stratification with a score chart based on symptoms and MACS could be a valuable tool to exclude a diagnosis of CMI in very lowrisk patients, in whom a further diagnostic workup can be omitted, and to identify patients with higher probability of CMI in whom further diagnostic investigations are warranted.…”

Section: Introductionmentioning

confidence: 99%

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Early risk stratification of patients with suspected chronic mesenteric ischaemia using a symptom and mesenteric artery calcium score based score chart

et al. 2021

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Background The mesenteric artery calcium score (MACS) identifies patients with possible chronic mesenteric ischaemia (CMI) using standard computed tomography (CT) imaging. The MACS does not necessitate a dedicated computed tomography angiography (CTA) which is required for evaluation of mesenteric artery patency. This study aimed to test the use of a symptom and MACS based score chart to facilitate the selection of patients with a low probability of CMI, in whom further diagnostic workup can be omitted, and to validate the CTA‐based score chart proposed by van Dijk et al. which guides treatment decisions in patients with suspected CMI. Methods This retrospective study included consecutive patients with suspected CMI. The Agatston definition was used to calculate the MACS. Multivariable logistic regression analysis was used to create a MACS score chart, which was applied in all patients to determine its discriminative ability. The score chart by van Dijk et al. was validated in this independent external patient series. Results Hundred‐ninety‐two patients were included, of whom 49 had CMI. The MACS score chart composed of the variables weight loss, postprandial abdominal pain, history of cardiovascular disease, and MACS, showed an excellent discriminative ability (area under the curve [AUC] 0.87). CMI risks were 2.1% in the low‐risk group (0–4 points) and 39.1% in the increased risk group (5–10 points); sensitivity (97.8%) and negative predictive value (NPV; 97.9%) were high. The CTA‐based score chart by van Dijk et al. showed an excellent discriminative ability (AUC 0.89). Conclusion The MACS score chart shows promise for early risk stratification of patients with suspected CMI based on a near‐perfect NPV. It is complementary to the CTA‐based score chart by van Dijk et al., which showed excellent external validity and is well suited to guide subsequent (invasive) treatment decisions in patients with suspected CMI.

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Section: Methodsmentioning

confidence: 99%

Section: Mesenteric Artery Calcium Scorementioning

confidence: 99%

Section: Mesenteric Artery Calcium Scorementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early risk stratification of patients with suspected chronic mesenteric ischaemia using a symptom and mesenteric artery calcium score based score chart

et al. 2021

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MRI-based pre- and postprandial flow in the mesenteric vasculature of patients with suspected chronic mesenteric ischemia

Terlouw

Dijk

Noord

et al. 2022

European Journal of Radiology

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Improvement of the splanchnic blood flow and hepatic vein oxygenation following revascularization in patients with chronic mesenteric ischaemia

Høyer

Stefanov

Abrahamsen

2022

Clin Physio Funct Imaging

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Objectives Chronic mesenteric ischaemia (CMI) is an underdiagnosed but severe condition. Access to functional testing is often limited and the diagnosis is usually based primarily on symptoms and imaging. One of the functional tests available is measurement of the splanchnic blood flow (SBF). The purpose of the present investigation was to evaluate if changes in the splanchnic perfusion after revascularization can be detected by measuring the SBF and hepatic vein oxygenation. Materials and Methods The SBF was measured in 10 patients before and after revascularization of the mesenteric arteries by either percutaneous transluminal angioplasty (n = 9) or open revascularization (n = 1). The SBF was measured indirectly using Fick's principle and using the tracer Tc‐99m Mebrofenin along with assessment of hepatic blood oxygenation, before and after a standard meal, following catheterization of a hepatic vein and the femoral artery. Results Nine of 10 patients (90%) achieved a profound increase in SBF after revascularization (mean increase in postprandial response to meal stimulation from 71 ± 95 to 531 ± 295 ml/min, p = 0.001), and an increase in postprandial hepatic vein oxygen saturation (from 52 ± 14% to 59 ± 13%, p = 0.006). The symptoms of the patients diminished accordingly. One patient had no symptom relief, and no increase in postprandial SBF, but an angiographic result with no significant stenosis postrevascularization. Conclusions Revascularization increased the SBF and hepatic vein oxygen saturation significantly concurrent with symptom relief and according with the angiographic successful result in the vast majority of patients. A satisfying angiographic result post vascular intervention does not rule out CMI.

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Mesenteric artery calcium scoring: a potential screening method for chronic mesenteric ischemia

Cited by 3 publications

References 26 publications

Early risk stratification of patients with suspected chronic mesenteric ischaemia using a symptom and mesenteric artery calcium score based score chart

Early risk stratification of patients with suspected chronic mesenteric ischaemia using a symptom and mesenteric artery calcium score based score chart

MRI-based pre- and postprandial flow in the mesenteric vasculature of patients with suspected chronic mesenteric ischemia

Improvement of the splanchnic blood flow and hepatic vein oxygenation following revascularization in patients with chronic mesenteric ischaemia

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