Multi–Detector Row CT of Mesenteric Ischemia: Can It Be Done?

Mesenteric ischemia is a complicated disorder whose prevalence in the United States is increasing as the population ages. It is often difficult to diagnose, both clinically and radiologically. In the past, computed tomography (CT) has allowed only limited success in the early detection of ischemia. However, with the introduction of multi-detector row CT and three-dimensional (3D) imaging, it is now possible to perform a detailed CT examination of the small bowel and mesenteric vessels. Multi-detector row CT allows routine studies to be performed much faster than with single-detector CT scanners and makes available new applications, especially in the field of CT angiography. Its increased speed and narrower collimation, coupled with the use of water as an oral contrast agent, improve visualization of the bowel wall and mesenteric vasculature. Multi-detector row CT 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. In many cases, this examination has eliminated the need for additional imaging studies such as Doppler ultrasonography or angiography. Further investigation will be needed to determine the scope of the utility of multi-detector row CT in this clinical setting.