Split-bolus single scan CTA for evaluation of mesenteric ischemia.

Area of Science:

• Radiology
• Medical Imaging
• Abdominal Imaging

Background:

• Acute mesenteric ischemia (AMI) is a critical condition requiring timely diagnosis.
• Conventional multiphasic CT angiography (CTA) protocols can involve significant radiation dose and image volume.
• Optimizing CTA protocols is essential for efficient and safe patient evaluation.

Purpose of the Study:

• To evaluate the efficacy of a split-bolus single scan CT angiography (CTA) protocol for diagnosing acute mesenteric ischemia.
• To compare the diagnostic performance and radiation dose of the split-bolus CTA protocol against a multiphasic CTA protocol.

Main Methods:

• A retrospective study included 80 patients evaluated for mesenteric ischemia, divided into multiphasic CTA (n=40) and split-bolus CTA (n=40) groups.
• Three radiologists assessed image quality, diagnostic confidence, and accuracy for mesenteric vessels and bowel.
• Clinical outcomes were correlated with imaging findings.

Main Results:

• Both protocols demonstrated similar high proportions of optimal enhancement for bowel, liver, and spleen (94-99%).
• Diagnostic confidence and accuracy were comparable between the groups, with no missed cases of mesenteric ischemia.
• The split-bolus protocol resulted in a 42% lower mean effective radiation dose and a significant reduction in the number of axial images to review.

Conclusions:

• The split-bolus single scan CTA protocol is a clinically feasible and effective method for evaluating acute mesenteric ischemia.
• This protocol offers comparable diagnostic accuracy to multiphasic CTA while significantly reducing radiation exposure and image burden.
• The findings support the adoption of split-bolus CTA for routine evaluation of suspected mesenteric ischemia.