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Multi–Detector Row CT Angiography in Patients with Abdominal Angina¹

¹ From the Department of Radiology, Erasmus Medical Center-Rotterdam, Dr Molenwaterplein 40, 3015 GD-Rotterdam, The Netherlands. Presented as an education exhibit at the 2002 RSNA scientific assembly. Received July 15, 2003; revision requested August 19 and received December 8; accepted December 11. All authors have no financial relationships to disclose. Address correspondence to F.C. (e-mail: filippocademartiri@hotmail.com).

Abdominal angina (AA) is an infrequently occurring syndrome characterized by postprandial abdominal pain due to reduced blood flow to organs in the territory of the celiac trunk, superior mesenteric artery (SMA), and inferior mesenteric artery. Multi–detector row computed tomographic (CT) angiography with four- or 16-row scanners has become a primary tool for the evaluation of patients with suspected steno-occlusive diseases of the abdominal vessels. In patients with suspected AA, multi–detector row CT angiography can help evaluate the presence and degree of stenosis in the celiac trunk and SMA, demonstrate the collateral circulation, and help exclude other causes of vascular obstruction. It also allows visualization of small vessels and of vessel wall abnormalities in the absence of significant stenosis. Vessels with a complex anatomic configuration can easily be visualized with proper postprocessing techniques. This modality can also be used to follow up patients who have undergone percutaneous interventional treatment. Limitations include the lack of dynamic representation of flow abnormalities and difficulty in evaluating heavily calcified vessels. Nevertheless, multi–detector row CT angiography with appropriate postprocessing techniques is highly effective for the diagnosis, evaluation, and treatment of suspected AA. Additional studies will help further evaluate the performance and applications of this modality.

© RSNA, 2004

Index Terms: Abdomen, CT, 95.12916 • Abdomen, diseases, 95.761 • Computed tomography (CT), angiography, 95.12916 • Computed tomography (CT), multi–detector row, 95.12916 • Computed tomography (CT), technology, 95.12916 • Mesentery, ischemia, 792.769

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