Mesenteric ischemia diagnostic study of choice: Difference between revisions
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{{CMG}}; {{AE}} {{FT}} | {{CMG}}; {{AE}} {{FT}} | ||
== Overview == | == Overview == | ||
The | The definitive diagnosis of mesenteric ischemia relies mainly on the imaging studies of which the most accurate is high resolution [[Computed Tomographic Angiography|computed]] tomographic angiography. It not only demonstrates the site of [[occlusion]] in the [[Blood vessel|vessels]] but also guides about making the correct choice of treatment. It has a [[Sensitivity (tests)|sensitivity]] of 94% and a [[Specificity (tests)|specificity]] of 95%. | ||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
=== Gold standard/Study of choice for mesenteric ischemia: === | === Gold standard/Study of choice for mesenteric ischemia: === | ||
* High resolution computed tomographic angiography (HRCTA) is the gold standard test for the diagnosis of mesenteric ischemia for the following reasons: | * High resolution [[Computed Tomographic Angiography|computed]] tomographic angiography (HRCTA) is the gold standard test for the [[diagnosis]] of mesenteric ischemia for the following reasons:<ref name="pmid21993179">{{cite journal| author=Barmase M, Kang M, Wig J, Kochhar R, Gupta R, Khandelwal N| title=Role of multidetector CT angiography in the evaluation of suspected mesenteric ischemia. | journal=Eur J Radiol | year= 2011 | volume= 80 | issue= 3 | pages= e582-7 | pmid=21993179 | doi=10.1016/j.ejrad.2011.09.015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21993179 }} </ref> | ||
** Confirms the diagnosis | ** Confirms the [[diagnosis]] | ||
** Determines the prognosis | ** Determines the [[prognosis]] | ||
** Identifies collateral circulation | ** Identifies collateral circulation | ||
** Potential sources of inflow | ** Potential sources of inflow | ||
** Determines the type of occlusion | ** Determines the type of [[occlusion]] | ||
'''Sensitivity and specificity:'''<ref name="CudnikDarbha2013">{{cite journal|last1=Cudnik|first1=Michael T.|last2=Darbha|first2=Subrahmanyam|last3=Jones|first3=Janice|last4=Macedo|first4=Julian|last5=Stockton|first5=Sherrill W.|last6=Hiestand|first6=Brian C.|last7=Jones|first7=Alan E.|title=The Diagnosis of Acute Mesenteric Ischemia: A Systematic Review and Meta-analysis|journal=Academic Emergency Medicine|volume=20|issue=11|year=2013|pages=1087–1100|issn=10696563|doi=10.1111/acem.12254}}</ref> | '''Sensitivity and specificity:'''<ref name="CudnikDarbha2013">{{cite journal|last1=Cudnik|first1=Michael T.|last2=Darbha|first2=Subrahmanyam|last3=Jones|first3=Janice|last4=Macedo|first4=Julian|last5=Stockton|first5=Sherrill W.|last6=Hiestand|first6=Brian C.|last7=Jones|first7=Alan E.|title=The Diagnosis of Acute Mesenteric Ischemia: A Systematic Review and Meta-analysis|journal=Academic Emergency Medicine|volume=20|issue=11|year=2013|pages=1087–1100|issn=10696563|doi=10.1111/acem.12254}}</ref> | ||
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===== Diagnostic results ===== | ===== Diagnostic results ===== | ||
The following | The following results of computed tomographic angiography is confirmatory of mesenteric ischemia: | ||
{| class="wikitable" | {| class="wikitable" | ||
! colspan="2" |Findings | ! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Findings | ||
|- | |- | ||
|Classic meniscus sign | |Classic [[meniscus]] sign | ||
| | | | ||
* Seen at the point of occlusion more commonly in acute embolic mesenteric occlusion | * Seen at the point of occlusion more commonly in [[acute]] [[embolic]] mesenteric occlusion | ||
* Proximal jejunal branches are filled quickly whereas distal branches are visualized minimally. | * Proximal jejunal branches are filled quickly whereas distal branches are visualized minimally. | ||
|- | |- | ||
|Multiple areas of narrowing and irregularity | |Multiple areas of narrowing and irregularity | ||
| | | | ||
* More commonly seen in non-occlusive mesenteric ischemia | * More commonly seen in [[Non-occlusive ischemia|non-occlusive]] mesenteric ischemia | ||
|} | |} | ||
==References== | ==References== | ||
Latest revision as of 20:43, 19 January 2018
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Mesenteric ischemia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Mesenteric ischemia diagnostic study of choice On the Web |
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American Roentgen Ray Society Images of Mesenteric ischemia diagnostic study of choice |
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Risk calculators and risk factors for Mesenteric ischemia diagnostic study of choice |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]
Overview
The definitive diagnosis of mesenteric ischemia relies mainly on the imaging studies of which the most accurate is high resolution computed tomographic angiography. It not only demonstrates the site of occlusion in the vessels but also guides about making the correct choice of treatment. It has a sensitivity of 94% and a specificity of 95%.
Diagnostic Study of Choice
Gold standard/Study of choice for mesenteric ischemia:
- High resolution computed tomographic angiography (HRCTA) is the gold standard test for the diagnosis of mesenteric ischemia for the following reasons:[1]
Sensitivity and specificity:[2]
| Do | Sensitivity | Specificity |
|---|---|---|
| High resolution computed tomographic angiography | 94% | 95% |
✔= The best test based on the feature
Diagnostic results
The following results of computed tomographic angiography is confirmatory of mesenteric ischemia:
| Findings | |
|---|---|
| Classic meniscus sign | |
| Multiple areas of narrowing and irregularity |
|
References
- ↑ Barmase M, Kang M, Wig J, Kochhar R, Gupta R, Khandelwal N (2011). "Role of multidetector CT angiography in the evaluation of suspected mesenteric ischemia". Eur J Radiol. 80 (3): e582–7. doi:10.1016/j.ejrad.2011.09.015. PMID 21993179.
- ↑ Cudnik, Michael T.; Darbha, Subrahmanyam; Jones, Janice; Macedo, Julian; Stockton, Sherrill W.; Hiestand, Brian C.; Jones, Alan E. (2013). "The Diagnosis of Acute Mesenteric Ischemia: A Systematic Review and Meta-analysis". Academic Emergency Medicine. 20 (11): 1087–1100. doi:10.1111/acem.12254. ISSN 1069-6563.