Evaluation of isolated abdominal visceral artery dissection with multi-scale spiral computed tomography: a retrospective case series

• Main Authors: Qizhou He, Fei Yu, Yajun Fu, Bin Yang, Ran Huo, Rong Xian, Shulan Liu, Kali Liang, Guangcai Tang
• Format: Article
• Language: English
• Published: BMC 2021-03-01
• Series: Journal of Cardiothoracic Surgery
• Subjects: Dissection; Visceral artery; Computed tomography; Yun classification
• Online Access: https://doi.org/10.1186/s13019-021-01428-8

Abstract Background To evaluate the role of multi-slice spiral computed tomography (MSCT) angiography in the diagnosis of spontaneous isolated visceral artery dissection (SIVAD). Methods Twenty-seven patients with abdominal SIVAD were included in the study. The MSCT scans of the patients were subjected to various post-processing techniques to visualize the visceral artery wall. Clinical features including arterial dissection, thrombosis, dissection length, true/false lumen, and complications were recorded. Results Type I, IIa, and IIb SIVADs were observed in 11, 6, and 10 patients, respectively. Superior mesenteric artery (SMA) dissection was the most common (n = 16), followed by abdominal aortic dissection (n = 6), splenic artery dissection (n = 2), renal artery dissection (n = 2), and splenic artery dissection (n = 1). One patient with SMA dissection suffered small intestine ischemia, 1 with splenic artery dissection had splenic infarction, and 1 patient with left renal artery dissection experienced renal infarction. The false lumen was bigger than the true lumen in 20 patients, with 9 patients having thrombus. The true lumen was bigger than the false lumen in 7 patients. Conclusions MSCT angiography is a valuable technique in the diagnosis and treatment of patients with SIVAD. Patients with abdominal pain suspected due to SIVAD should be examined with MSCT angiography for early detection of SIVAD.