Noninvasive evaluation of the celiac trunk and superior mesenteric artery with multislice CT in patients with chronic mesenteric ischaemia

• Published in: Radiologia medica Vol. 113; no. 8; pp. 1135 - 1142
• Main Authors: Cademartiri, F., Palumbo, A., Maffei, E., Martini, C., Malagò, R., Belgrano, M., La Grutta, L., Bartolotta, T.V., Luccichenti, G., Midiri, M., Raaijmakers, R., Mollet, N., Zompatori, M., Crisi, G.
• Format: Journal Article
• Language: English; Italian
• Published: Milan Springer Milan 01.12.2008
• Subjects: Abdominal Radiology/Radiologia Addominale; Adult; Aged; Aged, 80 and over; Angiography - methods; Celiac Artery; Diagnostic Radiology; Female; Humans; Imaging; Interventional Radiology; Ischemia - diagnostic imaging; Male; Medicine; Medicine & Public Health; Mesenteric Artery, Superior; Mesentery - blood supply; Mesentery - diagnostic imaging; Middle Aged; Neuroradiology; Radiology; Tomography, X-Ray Computed; Ultrasound; Angina addominale; Chronic mesenteric ischaemia; Abdominal angina; MSCT angiography; Ischemia cronica mesenterica; TC
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-008-0330-1

Purpose This study sought to assess the role of multislice computed tomography (MSCT) in patients with suspected chronic mesenteric ischaemia (CMI). Materials and methods Forty-five patients (29 men; mean age 68) underwent MSCT angiography of the abdomen for suspected CMI (main clinical finding: postprandial abdominal pain). The scan protocol was detectors/collimation 16/0.75 mm; feed 36 mm/s; rotation time 500 ms; increment 0.4 mm; 120–150 mAs and 120 kVp. A volume of 80 ml of contrast material was administered through an antecubital vein (rate 4 ml/s), followed by 40 ml of saline (rate 4 ml/s). Images were analysed on the workstation with different algorithms (axial image scrolling, multiplanar reconstructions, maximum intensity projection, volume rendering). Targeted central lumen-line reconstructions (curved reconstructions) were obtained along the celiac trunk (CeT) and superior mesenteric artery (SMA). Vessel occlusions and significant (>50%) stenosis were recorded. Results Image generation and interpretation required 25 min. Stenosis and/or occlusions were detected in 29 (65%) cases on the CeT and in 32 (71%) on the SMA. Of those lesions (n=61), 44 (49%) were classified as not significant. In 16 (35%) cases, there was a simultaneous stenosis and/or occlusion of the CeT and SMA (confirmed by conventional angiography). In six (13%) cases, there were no lesions affecting the CeT, SMA or their branches (confirmed by clinical follow-up). Conclusions MSCT angiography can play a major role in the detection of stenosis of the abdominal arteries in patients with suspected CMI.