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Computed Tomographic Evaluation of Mesentery: Diagnostic Value in Acute Mesenteric Ischemia

Mazzei, Maria Antonietta MD; Mazzei, Francesco Giuseppe MD; Marrelli, Daniele MD; Imbriaco, Giusi MD; Guerrini, Susanna MD; Vindigni, Carla MD; Civitelli, Serenella MD; Roviello, Franco MD; Grassi, Roberto MD; Volterrani, Luca MD

Journal of Computer Assisted Tomography: January/February 2012 - Volume 36 - Issue 1 - p 1–7
doi: 10.1097/RCT.0b013e31823b4465
Abdominal Imaging

Objective: To evaluate the computed tomographic appearances of mesentery in acute mesenteric ischemia (AMI) to recognize characteristic features and their prognostic values.

Methods: Computed tomographic examinations of 34 patients with a confirmed diagnosis of AMI were retrospectively reviewed to evaluate the number of mesenteric vessels, diameter of the superior mesenteric artery and superior mesenteric vein, mesenteric fat stranding, mesenteric vessel pneumatosis and ascites.

Results: Overall, at least one of these mesenteric signs was present in all but 1 patient. In all AMI of arterial occlusive type and in 68% of nonocclusive mesenteric ischemia, the number of arterial vessels was reduced (P = 0.067). Mesenteric vessel pneumatosis and reduced number of venous vessels were significantly associated with higher mortality (P = 0.027 and P = 0.042, respectively). Reperfusion signs were associated with a reduced mortality (28.7% vs 65.5%).

Conclusion: Considering its characteristic features and its possible prognostic value, the evaluation of mesentery will supply additional information in the interpretation of computed tomography in AMI.

From the *Section of Radiological Sciences, Department of Human Pathology and Oncology, University of Siena, Siena, Italy; †Department of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy; ‡Section of Surgical Oncology, Department of Human Pathology and Oncology, University of Siena, Siena, Italy; §Division of Pathological Anatomy, Azienda Ospedaliera Universitaria Senese, Siena, Italy; ∥Section of Surgery, Department of Human Pathology and Oncology, University of Siena, Siena, Italy; and ¶Institute of Radiology, Second University of Naples, Naples, Italy.

Received for publication August 4, 2011; accepted October 4, 2011.

Reprints: Maria Antonietta Mazzei, MD, Section of Radiological Sciences, Department of Human Pathology and Oncology, University of Siena, Viale Bracci 10, Siena 53100, Italy (e-mail: mariaantonietta.mazzei@unisi.it).

The authors report no conflicts of interest.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.