الفهرس 
ANATOMY OF MESENTERIC VESSELS BY MSCTOnly 14 pages are availabe for public view
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Abstract
Bowel ischemia or infarction is a common but complex disorder with various primary causes and clinical presentations and high mortality. It is caused by insufficient blood flow to the intestine from various causes, including thromboembolism, nonocclusive causes, bowel obstruction, neoplasm, vasculitis, abdominal inflammatory conditions, trauma, drugs (chemotherapy), radiation, and corrosive injury and manifest with typical or atypical and specific or nonspecific clinical, laboratory, and radiologic findings. It may mimic various intestinal diseases and be confused with certain nonischemic conditions.With the increase in average life expectancy bowel ischemia represents one of the most threatening abdominal conditions in elderly patients.
An accurate and early diagnosis is essential for the appropriate and successful treatment of patients with mesenteric ischemia to improve their prognoses. With the advances in CT technology, CT has realized a high diagnostic performance and become an essential diagnostic tool in this clinical setting. For a correct diagnosis, a technically appropriate CT examination and proper interpretation of images are mandatory. Because mesenteric ischemia can be caused by various conditions, the CT findings vary widely, depending on the cause and underlying pathophysiology and the presence of associated complications.
MSCT allows not only routine studies to be performed much faster than with single –detector CT scanners, but also makes available new applications in the field of CT angiography. The increased speed and narrower collimation of multi-detector row CT, coupled with the use of water as an oral contrast agent, improves visualization of the bowel wall and mesenteric vasculature. MSCT with 3D reformatting may improve the ability to make an early diagnosis and identify the cause of disease in patients with suspected acute or chronic mesenteric ischemia. The sensitivity and specificity rates 92%-96% and 94%-100% respectively.
Multi–detector row CT angiography can help evaluate the presence and degree of stenosis in the celiac trunk and SMA, demonstrate the collateral circulation, and help exclude other causes of vascular obstruction. It also allows visualization of small vessels and of vessel wall abnormalities in the absence of significant stenosis. Vessels with a complex anatomic configuration can easily be visualized with proper postprocessing techniques.
MSCT is a safe, fast and easy procedure that does not have the complications of catheterization of conventional angiography with its associated morbidity and mortality .MSCT angiography can be performed as an outpatient non invasive procedure with no need for hospitalization that is necessary after conventional angiography.
MSCT is the imaging tool of choice in diagnosis of mesenteric ischemia. It provides visualization of pathological conditions of the mesenteric vasculature in addition to delineation of the extra vascular intestinal abnormalities and can help detection of the primary cause of intestinal ischemia beside its role in ruling out other causes of acute abdomen in an easy , fast , non- invasive manner.