Comparison Of Different Post-processes Of Dual-source CT In Diagnosis Of Superior Mesenteric Artery Stenosis

Background Acute mesenteric ischemia is a highly lethal disease characterized by a fast progressive course leading to intestinal necrosis and death, Embolization of the superior mesenteric artery accounts for 50% of all casea, while 25% of cases are secondary to thrombosis of a pre-existent atherosclerotic lesion at the origin of the vessel. its diagnose only depend on DSA, but DSA it is take time and woke, it is a problem of diagnose early for doctor. MSCT scans rapid and simple, the effect of MSCT diagnose SMA ischemia should attach importance.DSA can display the change of blood speed and treat at the same time,but it have wound and result in some disease. MSCTA can display SMA and branch clearly, it also display the location and scope of disease. MSCT can view the change of intestinal wall and peritonaeum, it is benefit to judge the situation.Objective With the development of spiral CT and multi-slice CT technique,CT angiography has been applicated in abdomen from big vessel to midst small vessels and multi-slice CT angiography has been a effective technique in diagnosis of acute superior mesenteric artery ischemia.To evaluate the value of the post-processes of dual-source CT in the diagnosis of superior mesenteric artery (SMA) stenosis.Methods Twelve patients with SMA stenosis confirmed with digital subtraction angiography (DSA) and operation were enrolled. CT angiograms were reconstructed with multiplanar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR). With the results of DSA and operation as golden standard, the sensitivity,the specificity and accuracy of different CT post-processes in the diagnosis of SMA stenosis were statisticed, the accuracy of compared were evaluated with paired-samples X2 test.Results There are 5 patients with pure SMA stenosis,1 patient with SMA samdwich and cavity stenosis,6 patients with aorta samdwich and SMA cavity stenosis. DSA diagnoses 8 locates mild stenosis,15 locates stenosis,23 locates severe stenosis and 1 operation locate. The MPR, MIP and VR had a sensitivity of 75%,50%,25%, specificity of 96%,94%,93%, accuracy of 93%,91%,88% in diagnosis of mild stenosis; The MPR, MIP and VR had a sensitivity of 87%,60%,20%, specificity of 90%,85%,79%, accuracy of 90%,82%,72% in diagnosis of moderate stenosis; The MPR, MIP and VR had a sensitivity of 96%,92%,75%, specificity of 95%,92%,82%, accuracy of 95%,92%,80% in diagnosis of severe stenosis,respectively.Between MPR and MIP,there was no statistical significant difference(P>0.05) in diagnosing moderate and severe SMA stenosis; but between VR and MPR, there was statistical significant difference(P<0.05).5 patients with small intestine wall edema,3 patients with intestine cavity expand and 1 have abdomen water was found in Dual-source CT.Conclusion Each post-processing technology has an advantage, and integration of each other helps to diagnosing SMA stenosis accurately.