Imaging of acute mesenteric ischemia using multidetector CT and CT angiography in a porcine model

David E. Rosow, Dushyant Sahani, Oliver Strobel, Sanjeeva Kalva, Mari Mino-Kenudson, Nagaraj S. Holalkere, Guido Alsfasser, Sanjay Saini, Susanna I. Lee, Peter R. Mueller, Carlos Fernández Del Castillo, Andrew L. Warshaw, Sarah P. Thayer

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Acute mesenteric ischemia, a frequently lethal disease, requires prompt diagnosis and intervention for favorable clinical outcomes. This goal remains elusive due, in part, to lack of a noninvasive and accurate imaging study. Traditional angiography is the diagnostic gold standard but is invasive and costly. Computed tomography (CT) is readily available and noninvasive but has shown variable success in diagnosing this disease. The faster scanning time of multidetector row CT (M.D.CT) greatly facilitates the use of CT angiography (CTA) in the clinical setting. We sought to determine whether M.D.CT-CTA could accurately demonstrate vascular anatomy and capture the earliest stages of mesenteric ischemia in a porcine model. Pigs underwent embolization of branches of the superior mesenteric artery, then imaging by M.D.CT-CTA with three-dimensional reconstruction protocols. After scanning, diseased bowel segments were surgically resected and pathologically examined. Multidetector row CT and CT angiography reliably defined normal and occluded mesenteric vessels in the pig. It detected early changes of ischemia including poor arterial enhancement and venous dilatation, which were seen in all ischemic animals. The radiographic findings - compared with pathologic diagnoses - predicted ischemia, with a positive predictive value of 92%. These results indicate that M.D.CT-CTA holds great promise for the early detection necessary for successful treatment of acute mesenteric ischemia.

Original languageEnglish (US)
Pages (from-to)1262-1275
Number of pages14
JournalJournal of Gastrointestinal Surgery
Volume9
Issue number9
DOIs
StatePublished - Dec 1 2005

Keywords

  • Angiography
  • Animal model
  • Computed tomography
  • Mesenteric ischemia

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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    Rosow, D. E., Sahani, D., Strobel, O., Kalva, S., Mino-Kenudson, M., Holalkere, N. S., Alsfasser, G., Saini, S., Lee, S. I., Mueller, P. R., Castillo, C. F. D., Warshaw, A. L., & Thayer, S. P. (2005). Imaging of acute mesenteric ischemia using multidetector CT and CT angiography in a porcine model. Journal of Gastrointestinal Surgery, 9(9), 1262-1275. https://doi.org/10.1016/j.gassur.2005.07.034