Multislice spiral CT angiography of spontaneous splanchnic dissection

Objective: To investigate the clinical value of multislice CT angiography (MSCTA) for diagnosing spontaneous splanchnic dissection (SSD). Methods: Axial and post-processed CT images of 13 patients with SSD were retrospectively analyzed. Post-processing included volume rendering technique, multiplanar reconstruction, curved planar reformation and maximum intensity projection. The images were reviewed in consensus by two experienced cardiovascular radiologists. Results: Dissection was detected in the superior mesenteric artery (SMA) in 11 patients, in the celiac artery extending to splenic artery in 1 patient and additionally to the SMA in 1 patient. MSCTA showed the intimal flap (11), intimal tear at the proximal vessels and thrombi within false lumina (7). The dissection was categorized using Yun's classification of SMA dissection as types I (4), IIa (3), IIb (3) and III (1). The other associated findings on MSCTA were dilated SMA (2), indistinct fat plane surrounding the SMA (2), aneurysmal dilatation of SMA (1), focal ileum mural edema (2), distended ascending colon (1) and ascites (3). Nine patients responded to conservative treatment and two patients required open surgery. Conclusions: MSCTA is useful for detection and treatment planning of symptomatic SSD. (authors)