We performed a retrospective evaluation of direct and indirect signs of mesenteric ischemia at multi-detector CT in a population of patients with surgically or angiographically proven intestinal infarction.

CT exams of 48 patients with surgical (38) and angiographic (10) definitive diagnosis of intestinal infarction were retrospectively evaluated. In 28 patients the mesenteric ischemia had been caused by the obstruction of an artery, in 10 by the obstruction of a venous vessel. In the remaining 10 patients there was no obstruction and a diagnosis of non-occlusive intestinal infarction was made. All exams were performed in the arterial and venous phases after contrast media injection. A slice thickeness of 2.5 mm and a reconstruction interval...

The identification of the thrombus was possible in all 28 patients (100%) with arterial occlusive infarction and in all 10 patients (100%) with venoocclusive infarction. Indirect signs were appreciable in 22/28 patients (78%) with arterial occlusive infarction (bloodless mesentery, n = 11, wall thinning, n = 8, reflex ileus, n = 6, peritoneal fluid, n = 5) and in 8/10 patients (80%) with venoocclusive infarction ("clogged" mesentery, n = 6, wall thickening, n = 5, reflex ileus, n = 3, peritoneal fluid, n = 3)....

Our retrospective evaluation in a limited population revealed the high diagnostic accuracy of multi-detector CT in the identification of the site of occlusion of arterial or venous vessels in mesenteric infarction and in the definition of its extent. Indirect signs of mesenteric ischemia, whose identification is essential in the case of non-occlusive mesenterial infarction, are also well appreciable by multi-detector CT. This technique, thanks to its high spacial and contrast resolutions, allows a detailed assessment of the intestinal wall, of the mesentery and of the...

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