Clinical Application Of Multislice CT In Isolated Superior Mesenteric Artery (SMA) Dissection

PurposeTo analyze the clinical characters and manifestation of MSCT angiography of 11 isolated superior mesenteric artery (SMA) dissection cases, and evaluate the diagnostic value of the 64 slices CT in SMA dissection clinical application.MethodsWe retrospectively analyzed clinical data of 11 patients with isolated SMA dissection admitted in Guangdong hospital from January 2003 to March 2011, and reviewed the 107 cases reported in the literature. The clinical characters in early stage and imaging manifestation were summed up.All the patients underwent the MSCT examination. Post-processing with multi-planar reconstruction, maximum intensity projection and volume rendering methods demonstrated the true lumen, false lumen and intimal flap.ResultsPart 1The clinical characters of 11 isolated SMA dissection:①The number of male patients was more than that of female and the average age was 55 years. The patients in early stage were found in the recent years.②Early symptoms of the disease were recurrent episodes of moderate abdominal pain and bursting, sometimes with diarrhea, nausea and vomiting.③Abdominal examination:mild to moderate pain when press.④Normal blood biochemical examination results.⑤3 cases without uncomfortable feeling in the bell.⑥All the cases were diagnosed using MSCT without specific clinical characters.⑦All the patients healed after effective treatment. Part 2The imaging manifestations of 11 cases of isolate SMA dissection:①The low density intimal flap display:100%.②The true and false lumen display:100%.③The location of intimal entry and tear were shown satisfactorily in all cases. The distance between the location of intimal tear and the entrance of aorta abdominalis was 24.1 mm, and the average involvement was 48.5 mm.④The diameter of SMA was 12.7 mm.⑤8 cases with thrombus formed in SMA and 4 cases with thrombus formed in false lumen.⑥Thickening intestine wall because of insufficient blood supply.ConclusionsPart 1The early diagnosis rate is improved obviously of isolate SMA dissection because of the wide use of MSCT.Part 2Angiography of SMA by 64 slices CT may clearly display every changes of SMA. It should to be the new gold standard for SMA dissection diagnosis.