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Medline ® Abstract for Reference 64

of 'Overview of intestinal ischemia in adults'

Acute mesenteric ischemia: diagnosis with contrast-enhanced CT.
Taourel PG, Deneuville M, Pradel JA, Régent D, Bruel JM
Radiology. 1996;199(3):632.
PURPOSE: To evaluate the accuracy of dynamic, contrast material-enhanced computed tomography (CT) in the diagnosis of acute mesenteric ischemia.
MATERIALS AND METHODS: Reviewers blinded to patient diagnoses retrospectively compared the CT scans in a study group with those in a control group. The study group comprised 39 consecutive patients (23 men, 16 women; aged 55-88 years) with surgically proved acute mesenteric ischemia. The control group comprised 24 patients (13 men, 11 women; aged 50-82 years) with suspected acute mesenteric ischemia that was disproved at surgery.
RESULTS: For the diagnosis of acute mesenteric ischemia, each of the following findings had a specificity of more than 95% and a sensitivity of less than 30%: arterial or venous thrombosis, intramural gas, portal venous gas, focal lack of bowel-wall enhancement, and liver or splenic infarcts. When CT was used in the diagnosis of suspected acute mesenteric ischemia, the detection of at least one of these signs resulted in a sensitivity of 64% (25 of 39; confidence interval, 0.49, 0.79), a specificity of 92% (22 of 24; confidence interval, 0.81, 1.00), and an accuracy of 75% (47 of 63; confidence interval,0.64, 0.86).
CONCLUSION: Dynamic, contrast-enhanced CT is a valuable tool in the diagnosis of and determination of prognosis in acute mesenteric ischemia.
Department of Medical Imaging, Hôpital Saint-Eloi, Montpellier, France.