You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Isolated Celiac and Superior Mesenteric Artery Dissection Identified With MDCT: Imaging Findings and Clinical Course

Verde, Franco MD; Bleich, Karen B. MD; Oshmyansky, Alexander MD, PhD; Black, James H. MD; Fishman, Elliot K. MD; Johnson, Pamela T. MD

Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e318265129e
Abdominal Imaging
Abstract

Objective: Isolated celiac or superior mesenteric artery (SMA) dissection is a rare entity in the absence of aortic dissection. Our objective was to detail imaging and clinical course of celiac and or SMA dissections.

Methods: We conducted a retrospective search from 2004 to 2010 using “celiac and/or SMA dissection” keywords. Analysis of medical record and imaging at diagnosis and follow-up was performed. Dissections for any reason without aortic dissection were included.

Results: Twenty-four celiac and 18 SMA dissections were detected in 38 patients. One third of the dissections diagnosed with interactive multiplanar reconstruction/maximum intensity projection (MIP)/3-dimensional (3D) rendering were missed on standard imaging planes. No patients had bowel ischemia or died. Eighty-four percent of the patients were observed, 2 patients received anticoagulation, 2 patients received surgical repair, and 3 patients received stenting. Twenty-three of 25 cases treated with observation exhibited no change or improvement/resolution (2/25) with 20.9-month mean follow-up.

Conclusion: Most isolated celiac and SMA dissections were asymptomatic/incidental, supporting observation and surveillance with intervention reserved for vascular compromise. Interactive multiplanar reconstruction/maximum intensity projection/3D rendering can increase diagnostic sensitivity.

Author Information

From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD.

Received for publication May 10, 2012; accepted June 18, 2012.

Reprints: Franco Verde, MD, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287 (e-mail: FV fverde1@jhmi.edu).

The authors report no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.