Seung Soo Lee MD, Presenter: Nothing to Disclose

Jae Ho Byun MD, Abstract Co-Author: Nothing to Disclose

Yong Moon Shin MD, Abstract Co-Author: Nothing to Disclose

Hyung Jin Won MD, Abstract Co-Author: Nothing to Disclose

Ah Young Kim MD, Abstract Co-Author: Nothing to Disclose

Pyo Nyun Kim MD, Abstract Co-Author: Nothing to Disclose

Moon-Gyu Lee MD, Abstract Co-Author: Nothing to Disclose

Hyun Kwon Ha MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

to evaluate the potential role of CT in differentiating reversible ischemia from transmural necrosis in patients with acute mesenteric venous thrombosis

We retrospectively analyzed CT scans of 22 patients (M:F = 16:6, mean age = 55.3 ± 13.7 yrs) with acute mesenteric venous thrombosis. 11 patients underwent small bowel resection and diagnosed as transmural ischemic necrosis. The remaining 11 patients were treated with anticoagulation. They were considered to have reversible ischemia based on the clinical and CT follow-up. CT scans were performed using commercially available single detector spiral CT scanner (n=14) or multidetector-row CT scanner (n = 8) after intravenous injection of 100-150 mL of contrast material at 2.5-3mL/sec. CT scans were evaluated for the location of venous thrombus, the degree of bowel wall thickening and enhancement, the presence of bowel dilatation, the amount of ascites, and the extent of mesenteric haziness. We compared CT findings between the patients with transmural ischemic necrosis and reversible ischemia.

Venous thrombus was present in all the patients. All patients showed bowel wall thickening with mean thickness of 9.5 ± 3.2 mm (range, 5 – 17 mm). Decreased bowel wall enhancement (p = 0.001), large amount of ascites (p = 0.027), and diffuse mesenteric haziness (p = 0.24) were more frequently found in patients with transmural necrosis than those with reversible ischemia. For the diagnosis of transmural necrosis the sensitivity, specificity, and positive predictive value of those CT findings were as followed: decreased bowel wall enhancement, 91.8%, 90.9%, and 90%; large amount of ascites, 90.9%, 63.6%, and 71.4%; diffuse mesenteric haziness, 81.8%, 63.6%, and 69.2%, respectively. Other CT findings including location of venous thrombus (p = 0.097), the degree of bowel wall thickening (p = 0.7), and the presence of bowel dilatation (p = 0.28) did not show statistically significant difference.

In patients with acute mesenteric venous thrombosis, CT scan can be valuable not only in the diagnosis, but also in differentiating reversible ischemia from transmural necrosis

Lee, S, Byun, J, Shin, Y, Won, H, Kim, A, Kim, P, Lee, M, Ha, H, et al, , Usefulness of CT in Differentiating Reversible Ischemia from Transmural Necrosis in Patients with Acute Mesenteric Venous Thrombosis.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4414796.html