Findings in multi-detector row CT with portal phase enhancement in patients with mesenteric venous thrombosis

被引:45
作者
Acosta S. [1 ]
Alhadad A. [1 ]
Ekberg O. [2 ]
机构
[1] Vascular Centre, Malmö University Hospital
[2] Department of Radiology, Malmö University Hospital, Malmö
关键词
Intestinal ischemia; Mesenteric venous thrombosis; Multi-detector row CT;
D O I
10.1007/s10140-009-0807-9
中图分类号
学科分类号
摘要
There exists no systematic evaluation on the findings in multi-detector row computed tomography (MDCT) with portal phase enhancement in patients with mesenteric venous thrombosis (MVT). Patients with MVT between 2004 and 2006 were identified at Malmö University Hospital, Sweden. Thirty patients had MVT. Median age was 58 years (interquartile range, 46-72), and 57% (17) were men. MDCT with portal phase enhancement showed MVT in 19 out of 20 investigated patients at first evaluation, even though there was clinical suspicion in only one, and conservative management was possible in 19 (95%). Central and peripheral MVT was seen in 20 (100%) and six (30%) cases, respectively. Extra-hepatic and intra-hepatic portal and splenic vein thrombosis was seen in 17 (85%), nine (45%) and 15 (75%) cases, respectively. Venous collaterals were visible in 12 (60%) cases. The most frequent extra-vascular pathologies were mesenteric oedema (50%), ascites (40%), small bowel wall oedema (25%) and local small bowel wall dilatation (20%). The vascular findings in MVT are more pronounced than the intestinal findings in MDCT with portal phase enhancement, and evaluation of the mesenteric vessels should be included in routine MDCT scans for unclear acute abdomen. © 2009 Am Soc Emergency Radiol.
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页码:477 / 482
页数:5
相关论文
共 16 条
[1]  
Acosta S., Ogren M., Sternby N.-H., Bergqvist D., Bjorck M., Mesenteric venous thrombosis with transmural intestinal infarction: A population-based study, Journal of Vascular Surgery, 41, 1, pp. 59-63, (2005)
[2]  
Rhee R.Y., Gloviczki P., Mendonca C.T., Petterson T.M., Serry R.D., Sarr M.G., Et al., Mesenteric venous thrombosis: Still a lethal disease in the 1990s, J Vasc Surg, 20, pp. 688-697, (1994)
[3]  
Morasch M.D., Ebaugh J.L., Chiou A.C., Matsumura J.S., Pearce W.H., Yao J.S.T., Mesenteric venous thrombosis: A changing clinical entity, Journal of Vascular Surgery, 34, 4, pp. 680-684, (2001)
[4]  
Brunaud L., Antunes L., Collinet-Adler S., Marchal F., Ayav A., Bresler L., Boissel P., Acute mesenteric venous thrombosis: Case for nonoperative management, Journal of Vascular Surgery, 34, 4, pp. 673-679, (2001)
[5]  
Horton K.M., Fishman E.K., Multidetector CT Angiography in the Diagnosis of Mesenteric Ischemia, Radiologic Clinics of North America, 45, 2, pp. 275-288, (2007)
[6]  
Levy A.D., Mesenteric Ischemia, Radiologic Clinics of North America, 45, 3, pp. 593-599, (2007)
[7]  
Acosta S., Alhadad A., Svensson P., Ekberg O., Epidemiology, risk and prognostic factors in mesenteric venous thrombosis, Br J Surg, 10, pp. 1245-1251, (2008)
[8]  
Chou C.K., Mak C.W., Tzeng Y.H., Liu K.L., Chen J.M., CT of small bowel ischemia, Abdom Imaging, 29, pp. 18-22, (2004)
[9]  
Zhang J., Duan Z.Q., Song Q.B., Luo Y.W., Xin S.J., Zhang Q., Acute mesenteric venous thrombosis: A better outcome achieved through improved imaging techniques and a changed policy of clinical management, European Journal of Vascular and Endovascular Surgery, 28, 3, pp. 329-334, (2004)
[10]  
Orr D.W., Harrison P.M., Devlin J., Karani J.B., Kane P.A., Heaton N.D., O'Grady J.G., Heneghan M.A., Chronic Mesenteric Venous Thrombosis: Evaluation and Determinants of Survival During Long-Term Follow-up, Clinical Gastroenterology and Hepatology, 5, 1, pp. 80-86, (2007)