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

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S Acosta1, A Alhadad, O Ekberg

  • 1Vascular Centre, Malmö University Hospital, S205 02, Malmö, Sweden. stefan.acosta@telia.com

Emergency Radiology
|March 19, 2009
PubMed

Insights

Multi-detector row computed tomography (MDCT) with portal phase enhancement effectively detects mesenteric venous thrombosis (MVT). This imaging technique is crucial for diagnosing MVT, even when clinical suspicion is low, enabling conservative management in most cases.

Area of Science:

  • Radiology
  • Vascular Imaging
  • Gastrointestinal Imaging

Background:

  • Mesenteric venous thrombosis (MVT) diagnosis can be challenging.
  • Systematic evaluation of multi-detector row computed tomography (MDCT) findings in MVT is lacking.
  • Portal phase enhancement in MDCT is a key imaging technique.

Purpose of the Study:

  • To systematically evaluate MDCT findings with portal phase enhancement in patients with MVT.
  • To assess the diagnostic performance of MDCT in identifying MVT.
  • To correlate vascular and extra-vascular findings in MVT patients.

Main Methods:

  • Retrospective review of 30 patients diagnosed with MVT between 2004 and 2006.
  • Analysis of MDCT scans with portal phase enhancement.
  • Evaluation of central, peripheral, extra-hepatic, and intra-hepatic MVT, as well as venous collaterals and extra-vascular pathologies.

Main Results:

  • MDCT with portal phase enhancement detected MVT in 19 out of 20 investigated patients.
  • Central MVT was present in 100% of cases, with peripheral MVT in 30%.
  • Extra-vascular findings included mesenteric edema (50%), ascites (40%), and small bowel wall edema (25%).

Conclusions:

  • MDCT with portal phase enhancement is highly sensitive for detecting MVT.
  • Vascular findings in MVT are more pronounced than intestinal findings on MDCT.
  • Mesenteric vessel evaluation should be integrated into routine MDCT for acute abdomen diagnosis.

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