Multislice CT diagnosis of acute superior mesenteric arterial thromboembolism

Objective: To explore the multislice computed tomography (MSCT) findings of acute superior mesenteric artery (SMA) thromboembolism. Methods: The MSCT of 28 patients with acute SMA thromboembolism was analyzed retrospectively. All studies were performed without and with intravenous contrast injection in the arterial and venous phases with 3-D reconstruction. Results: Of 28 patients, there was primary SMA thromboembolism in 20, SMA dissection and secondary thromboembolism in 5, aortic dissection involving the SMA with secondary thromboembolism in 3. The SMA was hyperdense (22) or isodense (6) on non-enhanced MSCT with moderate stenosis (6), severe stenosis (4), or occlusion (18) on enhanced MSCT and CT angiography. Bowel wall thickening with abnormal contrast enhancement was seen in 14, bowel dilatation with mural thinning and no contrast enhancement in 8, normal intestinal wall thickness and enhancement in 6. Other MSCT findings included mesenteric cable signs (5), intestinal wall pneumatosis, portal vein and superior mesenteric venous gas (2), paralytic intestinal obstruction (5), ascites (5), Riolan arterial arch expansion (5). Conclusions: MSCT can aid the diagnosis of SMA thromboembolism and determine the degree of intestinal ischemia. (authors)