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The role of multislice computed tomography (MSCT) angiography in the diagnosis and therapy of non-occlusive mesenteric ischemia (NOMI) : Could MSCT replace DSA in diagnosis?

  • Objectives: Evaluation of multislice-CT (MSCT) during diagnosis and therapeutic decision-making in patients with suspected non-occlusive mesenteric ischemia (NOMI). Methods: Retrospective, institutional review board-approved study of 30 patients (20 men, 10 women, mean age 64.6±14.2 years, range 24-87 years) undergoing biphasic abdominal MSCT followed by digital subtraction angiography (DSA) due to suspected NOMI. MSCT and DSA were qualitatively and quantitatively evaluated independently by two radiologists with respect to the possible diagnosis of NOMI. MSCT analysis included quantitative measurements, qualitative evaluation of contrast enhancement and assessment of secondary findings (bowel wall thickening, hypo-enhancement, intestinal pneumatosis). MSCT diagnosis and secondary findings were compared against DSA diagnosis. Results: NOMI was diagnosed in a total of n = 28 patients. No differences were found when comparing the R1-rated MSCT diagnosis (p = 0.09) to the "gold standard", while MSCT diagnosis was slightly inferior with R2 (p = 0.02). With R1, vessel-associated parameters revealed the best correlation, i.e. qualitative vessel width (r = -0.39;p = 0.03) and vessel contrast (r = 0.45;p = 0.01). Moderate correlations were found for quantitative vessel diameters in the middle segments (r = -0.48,p = 0.01), increasing to almost high correlations in the distal (r = -0.66;p<0.00001) superior mesenteric artery (SMA) segments. No significant correlation was apparent from secondary findings. Conclusions: MSCT is an appropriate non-invasive method for diagnosing NOMI and leads to adequate and immediate therapeutic stratificatio

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Metadaten
Author:Sara Kammerer, Christoph Schuelke, Shoma Barbara BerkemeyerORCiD, Aglae Velasco, Walter HeindelORCiD, Michael Koehler, Boris BuerkeORCiD
Title (English):The role of multislice computed tomography (MSCT) angiography in the diagnosis and therapy of non-occlusive mesenteric ischemia (NOMI) : Could MSCT replace DSA in diagnosis?
URN:urn:nbn:de:bsz:959-opus-37776
DOI:https://doi.org/10.1371/journal.pone.0193698
ISSN:1932-6203
Parent Title (English):PLoS ONE
Document Type:Working Paper
Language:English
Year of Completion:2018
Release Date:2023/01/06
Tag:Angiography; Clinical; Computed axial tomography; Diagnostic medicine; Gastrointestinal tract; Ischemia; Mesentric arteries; Radiologists; Surgical and invasaive
Page Number:11
Faculties:Fakultät AuL
DDC classes:600 Technik, Medizin, angewandte Wissenschaften / 610 Medizin, Gesundheit
Review Status:Veröffentlichte Fassung/Verlagsversion
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International