Mesenteric ischemia diagnostic study of choice

	Mesenteric ischemia Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Mesenteric ischemia from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Guidelines for Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
CT
MRA
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Mesenteric ischemia diagnostic study of choice On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Mesenteric ischemia diagnostic study of choice All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Mesenteric ischemia diagnostic study of choice
CDC on Mesenteric ischemia diagnostic study of choice
Mesenteric ischemia diagnostic study of choice in the news
Blogs on Mesenteric ischemia diagnostic study of choice
Directions to Hospitals Treating Mesenteric ischemia
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]
- Confirms the diagnosis
- Determines the prognosis
- Identifies collateral circulation
- Potential sources of inflow
- Determines the type of occlusion

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	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.
Multiple areas of narrowing and irregularity	More commonly seen in non-occlusive mesenteric ischemia

References

Template:WH Template:WS

↑ 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.

[pmid21993179-1] 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.

[CudnikDarbha2013-2] 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.

[1]

[2]