Hiroyuki Tokue1, Yoshito Tsushima, Keigo Endo. 1. Department of Diagnostic and Interventional Radiology, Gunma University Hospital, Maebashi, Japan. tokue@s2.dion.ne.jp
Abstract
PURPOSE: To describe clinical and computed tomography (CT) findings of isolated dissection of the visceral arteries (IDVA). MATERIALS AND METHODS: We retrospectively analyzed clinical presentation and abdominal CT findings of 38 patients who were diagnosed as having an IDVA. IDVA were classified into three types based on CT findings: patent false lumen with re-entry (type I), patent false lumen without re-entry (type II), and completely thrombosed false lumen (type III). RESULTS: The dissection was located in the superior mesenteric artery (SMA) in 27 patients, celiac artery (CA) in 6, CA to splenic artery in 2, and common hepatic artery (CHA), CA to CHA, and inferior mesenteric artery (IMA) in 1 patient each. The dissection was classified into type I in 8 patients, type II in 12, and type III in 18. Surgical treatment was performed in 1 patient with type II SMA dissection because of bowel ischemia, although the remaining 37 patients were managed conservatively. Two cases with type II showed a progressive enlargement of the false lumen in follow-up CT. Increased density of the fat tissue around the affected visceral artery was more commonly seen in symptomatic patients compared to asymptomatic ones (P < 0.01). CONCLUSION: Based on our observation, patients with IDVA can be managed conservatively when there are no signs indicating organ ischemia.
PURPOSE: To describe clinical and computed tomography (CT) findings of isolated dissection of the visceral arteries (IDVA). MATERIALS AND METHODS: We retrospectively analyzed clinical presentation and abdominal CT findings of 38 patients who were diagnosed as having an IDVA. IDVA were classified into three types based on CT findings: patent false lumen with re-entry (type I), patent false lumen without re-entry (type II), and completely thrombosed false lumen (type III). RESULTS: The dissection was located in the superior mesenteric artery (SMA) in 27 patients, celiac artery (CA) in 6, CA to splenic artery in 2, and common hepatic artery (CHA), CA to CHA, and inferior mesenteric artery (IMA) in 1 patient each. The dissection was classified into type I in 8 patients, type II in 12, and type III in 18. Surgical treatment was performed in 1 patient with type II SMA dissection because of bowel ischemia, although the remaining 37 patients were managed conservatively. Two cases with type II showed a progressive enlargement of the false lumen in follow-up CT. Increased density of the fat tissue around the affected visceral artery was more commonly seen in symptomatic patients compared to asymptomatic ones (P < 0.01). CONCLUSION: Based on our observation, patients with IDVA can be managed conservatively when there are no signs indicating organ ischemia.
Authors: Nicholas D'Ambrosio; Barak Friedman; David Siegel; Douglas Katz; Amit Newatia; John Hines Journal: AJR Am J Roentgenol Date: 2007-06 Impact factor: 3.959