Isolated celiac and superior mesenteric artery dissection identified with MDCT: Imaging findings and clinical course

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Isolated celiac or superior mesenteric artery (SMA) dissection is a rare entity in the absence of aortic dissection. Our objective was to detail imaging and clinical course of celiac and or SMA dissections. METHODS: We conducted a retrospective search from 2004 to 2010 using "celiac and/or SMA dissection" keywords. Analysis of medical record and imaging at diagnosis and follow-up was performed. Dissections for any reason without aortic dissection were included. RESULTS: Twenty-four celiac and 18 SMA dissections were detected in 38 patients. One third of the dissections diagnosed with interactive multiplanar reconstruction/maximum intensity projection (MIP)/3-dimensional (3D) rendering were missed on standard imaging planes. No patients had bowel ischemia or died. Eighty-four percent of the patients were observed, 2 patients received anticoagulation, 2 patients received surgical repair, and 3 patients received stenting. Twenty-three of 25 cases treated with observation exhibited no change or improvement/resolution (2/25) with 20.9-month mean follow-up. CONCLUSION: Most isolated celiac and SMA dissections were asymptomatic/incidental, supporting observation and surveillance with intervention reserved for vascular compromise. Interactive multiplanar reconstruction/maximum intensity projection/3D rendering can increase diagnostic sensitivity.

Original languageEnglish (US)
Pages (from-to)539-545
Number of pages7
JournalJournal of computer assisted tomography
Volume36
Issue number5
DOIs
StatePublished - Sep 1 2012

Keywords

  • 3D
  • CT
  • mesenteric dissection
  • pseudoaneurysm

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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