Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery · 2025
[The importance of computed tomography with contrast and X-ray contrast angiography in the diagnosis of acute mesenteric circulatory disorders].
Аннотация на английскомСтатьяНазвание и аннотация: Оригинал на русском
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Kochetkov F D, Zaitsev O V, Suchkov I A
Аннотация
BACKGROUND: One of the main success factors in the treatment of patients with acute mesenteric ischemia is the timely diagnosis and the earliest possible start of treatment. The aim is to evaluate the diagnostic accuracy and specificity of computed tomography (CT) with intravenous contrast and X-ray contrast angiography in the diagnosis of acute mesenteric circulatory disorders.
MATERIAL AND METHODS: The work was carried out on the basis of two multidisciplinary hospitals of the third level, which include departments of general surgery and cardiovascular surgery. The study included 93 patients with suspected acute abdominal ischemia. CT angiography was performed in 68 of them, X-ray contrast angiography was performed in 14 of them, X-ray CT preceded endovascular intervention in 8 patients, and acute mesenteric ischemia was detected only intraoperatively after laparotomy in 28 patients after preliminary X-ray contrast examination.
RESULTS: The sensitivity of CT angiography was 72.6%, and the specificity was 80.2%. Due to the accuracy and the possibility of detailed visualization of the distal parts of the mesenteric bed, the sensitivity of endovascular interventions was 94.6%, and the specificity was 100%.
CONCLUSION: The use of X-ray contrast angiography is preferable in patients in stable condition with suspected acute mesenteric ischemia, regardless of the severity of changes in the intestinal wall. CT angiography is an accessible and non-invasive research method, it is the primary diagnostic method in patients in order to identify complications of acute mesenteric ischemia, as well as the only method applicable in the absence of endovascular diagnostic methods in the clinic.
MATERIAL AND METHODS: The work was carried out on the basis of two multidisciplinary hospitals of the third level, which include departments of general surgery and cardiovascular surgery. The study included 93 patients with suspected acute abdominal ischemia. CT angiography was performed in 68 of them, X-ray contrast angiography was performed in 14 of them, X-ray CT preceded endovascular intervention in 8 patients, and acute mesenteric ischemia was detected only intraoperatively after laparotomy in 28 patients after preliminary X-ray contrast examination.
RESULTS: The sensitivity of CT angiography was 72.6%, and the specificity was 80.2%. Due to the accuracy and the possibility of detailed visualization of the distal parts of the mesenteric bed, the sensitivity of endovascular interventions was 94.6%, and the specificity was 100%.
CONCLUSION: The use of X-ray contrast angiography is preferable in patients in stable condition with suspected acute mesenteric ischemia, regardless of the severity of changes in the intestinal wall. CT angiography is an accessible and non-invasive research method, it is the primary diagnostic method in patients in order to identify complications of acute mesenteric ischemia, as well as the only method applicable in the absence of endovascular diagnostic methods in the clinic.