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