Non-occlusive mesenteric ischaemia: CT findings, clinical outcomes and assessment of the diameter of the superior mesenteric artery
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OBJECTIVE: Review of the experience of a tertiary care centre for almost 10 years in the CT diagnosis of non-occlusive mesenteric ischaemia (NOMI). Analysis of CT findings, correlation with clinical outcomes and evaluation of the usefulness of measuring the superior mesenteric artery (SMA) diameter for the diagnosis of NOMI. METHODS: 106 patients were diagnosed with NOMI in a biphasic CT examination from 2008 to 2017 in our hospital. Clinical outcomes and CT findings were reviewed. In 55 patients, the diameter of the SMA was compared with a previous CT scan where NOMI was not the diagnosis, and statistical analysis using paired t-test was performed. RESULTS: 81 patients (76%) had findings consistent with small bowel ischaemia and the ileum was the segment most commonly involved (47%). Lack of wall enhancement, pneumoperitoneum, pneumatosis intestinalis and portal venous gas were all considered signs of bowel necrosis and surgery was performed promptly. 70 patients had signs of vascular narrowing of the SMA branches and in the 55 cases with a previous CT scan, there were statistically significant differences regarding the SMA diameter with a mean reduction of the artery calibre and standard deviation of 1.93 ± 1.1 mm between the NOMI and non-NOMI scans (p < 0.001). CONCLUSION: Acknowledgment of characteristic bowel necrosis CT findings is crucial for determining the therapeutic attitude and the use of previous CT scans to compare the SMA diameter may help the radiologist to achieve an early diagnosis of NOMI in an often critically ill patient population. Advances in knowledge: Diagnosis of NOMI can be difficult in cases of partial mural ischaemia, thus objective data (diameter of the SMA) should be useful for the radiologist to include NOMI as the first diagnostic option in the differential diagnosis.
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In 55 patients with NOMI, the mean diameter of the SMA decreased from 7.32 mm to 5.39 mm.
“In 55 patients with NOMI, the mean diameter of the SMA decreased from 7.32 mm to 5.39 mm. 195”
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Acute Mesenteric Ischemia: Imaging Findings and Mimics
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Computed Tomography Imaging of Acute Mesenteric Ischemia for Interventional Radiology
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Toda, Y., Komatsu, S., Fukami, Y., Saito, T., Matsumura, T., Osawa, T., Kurahashi, S., Uchino, T., Kato, S., Yasui, K., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20003610
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- Authors
- Pérez-García, C., de Miguel Campos, E., Fernández Gonzalo, A., Malfaz, C., Martín Pinacho, J. J., Fernández Álvarez, C., & Herranz Pérez, R.
- Affiliations
- Hospital General Universitario Gregorio Marañón (ES)
- Department of Radiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de la Princesa, Madrid, Spain
- ORCID
- Pérez-García, Carlos
- Venue
- The British Journal of Radiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-10-27
- Volume
- 91
- Issue
- 1081
- Pages
- 20170492-20170492
- ISSN
- 0007-1285 (ISSN-L)
- 1748-880X
- PMC
- PMC5966212
- OpenAlex
- W2761423258
- Cited by
- 81
- References
- 31
- Citations by year
- 2026: 10 · 2025: 10 · 2024: 9 · 2023: 8 · 2022: 15 · 2021: 8 · 2020: 14 · 2019: 4 · 2018: 2
- FWCI
- 5.60
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- British Journal of Radiology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Surgery › Vascular anomalies and interventions
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- nonocclusive mesenteric ischemia, small bowel ischemia, intestinal necrosis, computed tomography diagnosis, ileal involvement, pneumoperitoneum, pneumatosis intestinalis, portal venous gas, early diagnosis, clinical outcomes
- MeSH terms
- Aged, Female, Humans, Intestinal Perforation, Intestines, Male, Necrosis, Pneumoperitoneum, Retrospective Studies, Tomography, X-Ray Computed, Mesenteric Artery, Superior, Mesenteric Ischemia
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