AJR:189, October 2007
Jennifer K. Chen, Pamela T. Johnson, Karen M. Horton, Elliot K Fishman
OBJECTIVE. The purpose of our study was to determine how frequently significant mesen- teric arterial abnormalities that were identified by interactive 3D CT with volume rendering and maximum intensity projection were detected by axial images alone in a series of patients for whom there was no clinical suspicion of mesenteric vascular disease. Axial CT and 3D interpre- tations were compared for lesions involving the celiac and superior mesenteric arteries or their branches. On a per-patient basis, the axial and 3D interpretations were equivalent in 24% (10/41) of the cases. Axial CT partially agreed with 3D CT in 10% (4/41), and no mesenteric arterial lesion was reported on axial CT in 66% (27/41). The 3D CT findings were supported by other imaging, surgery, clinical findings, or management in 49% (20/41) of the cases. The mesenteric lesions identified resulted in a change in patient management in 15% (6/41) of the subjects.
CONCLUSION. Unsuspected mesenteric arterial abnormality may elude diagnosis when axial MDCT sections are interpreted without 3D renderings.