Reliability of Multi-Detector CT in the Assessment of Mesenteric Ischemia Using Basic Images

Abstract Background: Mesenteric ischemia is caused by drop of blood flow in intestinal vasculature to a degree that compromise the viability of target part and according to the time and amount of reduction, it can be classified into acute mesenteric ischemia and chronic mesenteric ischemia. Aim of Study: To assess the value of Multidetector CT (MDCT) and CT Angiography (CTA) in the diagnosis of different causes of mesenteric ischemia using the source images and routine reformat. Material and Methods: This prospective study included 58 consecutive patients (30 males and 28 females), with age range (52-77 years) during the period from October 2017 to Dec. 2018. They were referred for CT angiography of the mesenteric vessels with clinical suspicious of (acute or chronic) mesenteric ischemia. Four patients were exclude due to contraindication to IV contrast, so finally the study was conducted for 54 patients, all underwent CT angiography and the results of CT angiography were collected and tabulated. Results: Twenty four subjects had CTA findings of me-senteric ischemia (acute=14 and chronic=10). Thickening of bowel wall was the commonest finding in Acute Mesenteric Ischemia (AMI) in 85.7%. Bowel wall non-enhancement was noted in 11 patients of 14 with AMI (78.57%). CTA pointed out the cause of AMI in 14 patients (dominant cause was arterial thromboembolism, (n=10 (71.4 %)), the most frequent site was Superior Mesenteric Artery (SMA). CTA diagnosed and found out the reason of pain in Chronic Mesenteric Ischemia (CMI) patients (atherosclerosis of the splanchnic arteries with significant stenosis or occlusion was the dominant reason (n=7, 70%). Among the 24 patients with mesenteric ischemia, MDCT and CTA provided the reason for mesenteric ischemia in all patients which represents accuracy, sensitivity and specificity of 100%. Conclusion: MDCT and CTA are noninvasive tools that can be the optimum choice in imaging of cases with suspicious mesenteric ischemia.