ACUTE MESENTERIC ISCHEMIA DIAGNOSIS WITH CONTRAST-ENHANCED CT

PURPOSE: To evaluate the accuracy of dynamic, contrast material-enhanc ed computed tomography (CT) in the diagnosis of acute mesenteric ische mia. MATERIALS AND METHODS: Reviewers blinded to patient diagnoses ret rospectively compared the CT scans in a study group with those in a co ntrol group. The study group comprised 39 consecutive patients (23 men , 16 women; aged 55-88 years) with surgically proved acute mesenteric ischemia. The control group comprised 24 patients (13 men, 11 women; a ged 50-82 years) with suspected acute mesenteric ischemia that was dis proved at surgery. RESULTS: For the diagnosis of acute mesenteric isch emia, each of the following findings had a specificity of more than 95 % and a sensitivity of less than 30%: arterial or venous thrombosis, i ntramural gas, portal venous gas, focal lack of bowel-wall enhancement , and liver or splenic infarcts. When CT was used in the diagnosis of suspected acute mesenteric ischemia, the detection of at least one of these signs resulted in a sensitivity of 64% (25 of 39; confidence int erval, 0.49, 0.79), a specificity of 92% (22 of 24; confidence interva l, 0.81, 1.00), and an accuracy of 75% (47 of 63; confidence interval, 0.64, 0.86).CONCLUSION: Dynamic, contrast-enhanced CT is a valuable t ool in the diagnosis of and determination of prognosis in acute mesent eric ischemia.