Ultra low dose CT for non-traumatic abdominal emergencies: Current challenges and opportunities

Patlas, Michael N.

doi:10.1016/j.diii.2021.02.011

Cited by 6 publications

(1 citation statement)

References 10 publications

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“…Indeed, NOMI is the ultimate consequence of prolonged gut hypoperfusion and has a poor prognosis. Abdominal CT has a major role as an initial diagnostic modality in abdominal emergencies [28][29][30], but also in critically ill patients [7,22] by detecting bowel ischemia and necrosis. Further studies will now have to focus on earlier steps of gastro-intestinal failure such as such as a potential correlation between CT features and biomarkers of endothelial dysfunction [31], but also with biomarkers of mucosal gut damage [32], and their association with intra-abdominal pressure.…”

Section: Discussionmentioning

confidence: 99%

Abdominal atherosclerosis is not a risk factor of nonocclusive mesenteric ischemia among critically ill patients: a propensity matching study

Konan

Piton²,

Ronot

et al. 2022

Ann. Intensive Care

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Background Although risk factors of occlusive acute mesenteric ischemia are well known, triggering factors of nonocclusive mesenteric ischemia (NOMI) remain unclear. Alongside to the known risk factors for NOMI, the role of atherosclerosis is not fully elucidated. The purpose of our study was to evaluate whether abdominal atherosclerosis is a risk factor for NOMI. Methods From January 2018 to December 2021, all consecutive patients admitted to the intensive care unit who underwent contrast-enhanced CT for suspicion of NOMI were evaluated for inclusion. Clinical and biological data at the time of the CT scan were retrospectively extracted from medical charts and reviewed by a single radiologist. The cohorts were matched by a 1:1 propensity score based on the patient clinical, biological data, and abdominal CT features associated with NOMI. Noncontrast CT acquisitions were used to calculate calcium scores of the abdominal aorta, celiac trunk, superior mesenteric artery (SMA), and common iliac artery according to the Agatston method. Analyses were performed before and after propensity score matching. Results Among the 165 critically ill patients included, 59 (36%) had NOMI. Before matching analysis, the SMA and total abdominal Agatston calcium scores were not different between patients without and with NOMI (52.00 [IQR = 0, 473] vs. 137.00 [IQR = 0, 259], P = 0.857, respectively, and 7253 [IQR = 1220, 21738] versus 5802 [IQR = 2075, 15,084]; P = 0.723). The results were similar after matching 38 patients with NOMI and 38 without: 153 [IQR = 0, 665] versus 85 [IQR = 0, 240] (P = 0.312) for the SMA calcium score, and 7915 [IQR = 1812, 21561] versus 4139 [IQR = 1440, 9858] (P = 0.170) for the total abdominal Agatston calcium score. Conclusion Our results suggest that atherosclerosis is not a risk factor for NOMI in critically ill patients.

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