Spontaneous Isolated Superior Mesenteric Artery Dissection Image Characters、Clinical Features And Outcome

Objective:Analyze initial CT characters and clinical features of SISMAD.Discuss image and symptom changes of symptomatic SISMAD and its significance in different stages.3.Preliminary analyze the outcomes of SISMAD.Methods:Retrospectively reviewed the medical records and MSCT image findings of 65 patients diagnosis and treat in our hospital between August 2007 and August 2017,which included 54 symptomatic and 11 asymptomatic patients.1.Multi-slice spiral CT angiography(MSCTA)and multiple post-processing techniques were used to evaluate the image characters of SIDSMA and classified the type according to Yun’s new classification.2.Statistics software was used to compare the image and clinical features between the symptomatic and asymptomatic groups.3.Morphologic and clinical changes of the symptomatic group in different stage were counted separately and compared the difference by the Chi-Square Test.Results:1.The average age is 52.93±7.25 of symptomatic group while 61.27 ±10.00 of asymptomatic group,which has statistical significance(p=0.002).2.The classification,dissection range,branch vessel involvement and periarterial fatty infiltration differed between the symptomatic and asymptomatic groups(P<0.001,p<0.001,p=0.016,p=0.001).3.The clinical changes of symptomatic SIDSMA were all different separately in acute stage,subacute stage,chronic stage(p<0.001,p<0.001,p<0.001).The morphologic changes of symptomatic SIDSMA were different separately in subacute stage,chronic stage(p=0.001,p<0.001),but no statistical significance in acute stage(p=0.107).The morphologic outcomes after conservative treatment differed between the symptomatic and asymptomatic groups(p=0.003).Conclusion:1.SISMAD likely occurred in male of 50s age,and abdominal pain was the main symptom but rare severe diarrhoea,bloody stool and peritoneal irritation which indicated bowel ischemia or aneurysm rupture.2.Type Ilb accounted for a large proportion of symptomatic SISMAD,while Ila might be the main type of the asymptomatic patients.The longer dissection range,branch vessel involvement and periarterial fatty infiltration usually occurred in symptomatic patients.3.Symptomatic SISMAD tend to be instability and variable during acute stage while be stable and improve in subacute or chronic stage.