Limited utility of MRA for acute bowel ischemia after portal venous phase CT

Verfasser / Beitragende:
[Anup Shetty, Vincent Mellnick, Constantine Raptis, Ronald Loch, Joseph Owen, Sanjeev Bhalla]
Ort, Verlag, Jahr:
2015
Enthalten in:
Abdominal Imaging, 40/8(2015-10-01), 3020-3028
Format:
Artikel (online)
ID: 605494762
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024 7 0 |a 10.1007/s00261-015-0492-y  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00261-015-0492-y 
245 0 0 |a Limited utility of MRA for acute bowel ischemia after portal venous phase CT  |h [Elektronische Daten]  |c [Anup Shetty, Vincent Mellnick, Constantine Raptis, Ronald Loch, Joseph Owen, Sanjeev Bhalla] 
520 3 |a Purpose: Mesenteric ischemia and ischemic colitis are uncommon but potentially life-threatening causes of acute abdominal pain. Portal venous phase computed tomography (CT) is routinely ordered in the emergency room setting for abdominal pain, but subsequent MR angiography may be requested for additional evaluation of the mesenteric vasculature. We compare the concordance of CT and magnetic resonance angiography (MRA) for acute bowel ischemia. Materials and Methods: Thirty-two patients who underwent contrast-enhanced MRA for bowel ischemia after having undergone CT evaluation within the preceding 2 weeks were identified. A retrospective review of imaging, treatment history, surgical, and pathology reports was conducted. Two radiologists each reviewed the imaging studies in a blinded fashion. Results: Ten cases of bowel ischemia were confirmed by endoscopy and/or surgical pathology. CT correctly identified bowel findings in all cases. Intraobserver agreement between CT and MRA for all vessels was 0.68 and 0.63, highest for the superior mesenteric artery. Interobserver agreement was 0.74 for MRA and 0.78 for CT. Vascular findings were only directly mentioned in 10 of 32 CT reports (and 7 of 10 cases with confirmed bowel ischemia). MRA only detected two additional or alternative diagnoses. Conclusion: Portal venous phase CT and MRA demonstrate a high degree of concordance for vascular evaluation. Reviewed CT examinations were sufficient to assess the patency of the mesenteric vasculature, but vascular findings were not reported in most cases. A direct description within the report may have obviated the request for further MR imaging. MRA adds little value after portal venous CT in assessing bowel ischemia. 
540 |a Springer Science+Business Media New York, 2015 
690 7 |a Mesenteric ischemia  |2 nationallicence 
690 7 |a Ischemic colitis  |2 nationallicence 
690 7 |a Magnetic resonance angiography  |2 nationallicence 
690 7 |a Computed tomography  |2 nationallicence 
690 7 |a Portal venous CT  |2 nationallicence 
700 1 |a Shetty  |D Anup  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
700 1 |a Mellnick  |D Vincent  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
700 1 |a Raptis  |D Constantine  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
700 1 |a Loch  |D Ronald  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
700 1 |a Owen  |D Joseph  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
700 1 |a Bhalla  |D Sanjeev  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
773 0 |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/8(2015-10-01), 3020-3028  |x 0942-8925  |q 40:8<3020  |1 2015  |2 40  |o 261 
856 4 0 |u https://doi.org/10.1007/s00261-015-0492-y  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
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950 |B NATIONALLICENCE  |P 700  |E 1-  |a Shetty  |D Anup  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Mellnick  |D Vincent  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Raptis  |D Constantine  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Loch  |D Ronald  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Owen  |D Joseph  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Bhalla  |D Sanjeev  |u Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/8(2015-10-01), 3020-3028  |x 0942-8925  |q 40:8<3020  |1 2015  |2 40  |o 261