caa a22 4500 605494762 CHVBK 20210128100528.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0492-y doi (NATIONALLICENCE)springer-10.1007/s00261-015-0492-y Limited utility of MRA for acute bowel ischemia after portal venous phase CT [Elektronische Daten] [Anup Shetty, Vincent Mellnick, Constantine Raptis, Ronald Loch, Joseph Owen, Sanjeev Bhalla] 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. Springer Science+Business Media New York, 2015 Mesenteric ischemia nationallicence Ischemic colitis nationallicence Magnetic resonance angiography nationallicence Computed tomography nationallicence Portal venous CT nationallicence Shetty Anup Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut Mellnick Vincent Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut Raptis Constantine Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut Loch Ronald Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut Owen Joseph Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut Bhalla Sanjeev Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/8(2015-10-01), 3020-3028 0942-8925 40:8<3020 2015 40 261 https://doi.org/10.1007/s00261-015-0492-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0492-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shetty Anup Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut NATIONALLICENCE 700 1- Mellnick Vincent Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut NATIONALLICENCE 700 1- Raptis Constantine Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut NATIONALLICENCE 700 1- Loch Ronald Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut NATIONALLICENCE 700 1- Owen Joseph Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut NATIONALLICENCE 700 1- Bhalla Sanjeev Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8131, 63110, Saint Louis, MO, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/8(2015-10-01), 3020-3028 0942-8925 40:8<3020 2015 40 261