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Application value of MSCT angiography for spontaneous isolated superior mesenteric artery dissection |
YAN Su, SHAN Hai-rong, LIU Yi-wen, MIN Zhi-gang, JI Ai-bing |
Jiangsu University Affiliated Yixing Hospital, Yixing Jiangsu 214200, China |
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Abstract Objective: To investigate the value of MSCT angiography and post-processing technique in the diagnosis, treatment and follow-up of spontaneous isolated superior mesenteric artery dissection(SISMAD). Methods: 46 patients with SISMAD admitted from December 2012 to October 2016 were included in this study. The clinical presentation, MSCTA characteristics, clinical outcome and follow-up CT changes were analyzed retrospectively. Sakamoto classification was made. Results: The tearing site, intimal-flap, true and false lumens, and thrombus of SISMAD were clearly displayed on MSCTA images. According to Sakamoto's classification, 11 patients were categorized into typeⅠ, 4 patients were type Ⅱ, 26 patients were type Ⅲ, and 5 patients were type Ⅳ. The location of intimal tear was (25.2±6.5)mm distal from the SMA origin on CT, the median length of dissection was (75.4±4.3)mm. 44 patients underwent conservative treatment, and 2 patients were performed in endovascular intervention, all patients presented good curative effect. The follow-up MSCTA showed complete remodeling in 2 patients, partial remodeling in 9 patients, and no changes in 33 patients. Conclusion: MSCTA and post-processing technique can clearly and fully display the characteristic features of SISMAD, which is very helpful for clinical diagnosis, treatment and follow-up management.
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Received: 20 March 2017
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