Abstract:Aim To investigate the manifestations of several common acute superior mesenteric artery events of multi-slice spiral CT angiography (MSCTA) in order to acknowledge the disease deeply. Methods The clinical and imaging data of 23 cases of acute superior mesenteric artery were reviewed and summarized. Results 9 of 23 cases were isolated superior mesenteric artery dissection(ISMAD),according to classification of YUN,the type Ⅰ(n=7) and the type Ⅱb(n=2),double-lumen sign and low-density intimal flap were seen in all cases. 3 of 23 cases were intramural haemorrhagic(IMH) with out-pouching ulcer crater. 11 of 23 cases were acute superior mesenteric arter thromboembolism(SMAT), the direct signs of which in CT images was filling defect in mesenteric vessels. Conclusion Although the clinical symptoms of ISMAD,IMH and SMAT are similar,but each with typical imaging findings on MSCTA ,which is accurate, fast and effective for the diagnosis of acute superior mesenteric artery events.

Abstract:Aim To analyze the manifestations and outcomes of multi-slice spiral CT angiography (MSCTA) in isolated superior mesenteric artery dissection (ISMAD). Methods The CT data of 14 cases of isolated superior mesenteric artery dissection were retrospectively analyzed by Xiong Jiangs ISMAD image typing method. Results Among the 14 patients, 5 cases were Ⅰ type, 1 case was Ⅱ type, 6 cases were Ⅲ type and Ⅲa, 1 case was Ⅳ type, and 1 case was Ⅴ type. After conservative treatment, 4 cases were followed up, 1 case of Ⅰ type true cavity patency, 1 case of type Ⅰ without change, 1 case of Ⅲa type bag ulcer expansion, 1 case of Ⅲa type false lumen scope expansion, with true cavity further compression narrowed. Conclusion Xiong Jiangs ISMAD image typing method is accurate, rapid and effective for MSCTA diagnosing isolated superior mesenteric artery dissection. It is helpful to evaluate the dynamic changes and outcome of isolated superior mesenteric artery dissection.

Abstract:AimTo discuss and evaluate the diagnosis, differenis surgical techniques and prognosis of superior mesenteric artery occlusion(SMAO). Methods38 cases of acute superior mesenteric artery occlusion were treated with individualized surgical methods.Acute abdominal pain was the important clinical presentation.All the patients were diagnosed as SMAO by computed tomography arteriography (CTA) before treatment.According to individual condition, 38 patients accepted revascularizations including transcatheterizing thrombolysis, thromboembolectomy, ballon dilatation and stent implant, autologous vein or vascular prosthesis bypass/transplantation and resection of necrotic bowel respectively.ResultsIncision healed by first intention in all patients were followed up 6 months.The circulation of the intestine returned to normal in 30 patients by reexamination of color doppler ultrasonography.4 cases developed short-gut syndrome after operation and 3 cases died, and 2 cases developed intestinal fistula with death of 1 case; Severe infection and multiple organ failure was found in 3 patients and 2 cases died; And there were 6 patients with reperfusion injury, and 6 patients with deterioration of the primary affection and 2 of them died of heart failure.The overall incidence of postoperative complication was 55.2% and the overall mortality rate was 21.1%.ConclusionEarly recognization by appropriate examination and early treatment with individualized surgical methods will improve the prognosis of SMAO.