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Review
. 2020 Oct;45(10):2960-2979.
doi: 10.1007/s00261-019-02165-2.

The radiologist's guide to duplex ultrasound assessment of chronic mesenteric ischemia

Margarita V Revzin  1 , John S Pellerito  2 , Nariman Nezami  3 , Mariam Moshiri  4
Affiliations
Review

The radiologist's guide to duplex ultrasound assessment of chronic mesenteric ischemia

Margarita V Revzin et al. Abdom Radiol (NY). 2020 Oct.

Abstract

Objective: This article reviews the relevant anatomy and physiology of the mesenteric vasculature, familiarizes the radiologist with the accepted diagnostic criteria for mesenteric artery stenosis and its role in the diagnosis of chronic mesenteric ischemia, describes Doppler imaging techniques, and provides protocols for the assessment and surveillance of the mesenteric vasculature before and after revascularization. It also discusses expected changes following revascularization and reviews common post-procedural complications.

Results: Duplex sonography plays an important role in the diagnosis and management of chronic mesenteric ischemia (CMI). Establishing a successful diagnosis is dependent upon knowledge of mesenteric arterial anatomy and physiology as well as sufficient expertise in image optimization and scanning techniques. Although there has been a trend toward utilization of other noninvasive [computed tomographic angiography (CTA), magnetic resonance angiography (MRA), and invasive (digital subtraction angiography (DSA)] imaging modalities for assessment of the mesenteric vasculature, a new era of "imaging wisely" raises legitimate concerns about the effects of ionizing radiation as well as potential effects of CT and MR contrast agents. These concerns are obviated by the use of ultrasound, and recently developed techniques, such as contrast-enhanced ultrasound and vascular applications focused on the evaluation of slow flow, have revealed the vast potential of vascular ultrasound in the evaluation of chronic mesenteric ischemia.

Conclusion: Duplex sonography is a cost-effective and powerful tool that can be utilized for the accurate assessment of mesenteric vascular pathology, specifically mesenteric arterial stenosis, and for the evaluation of mesenteric arterial system post revascularization.

Keywords: Celiac artery Doppler; Chronic mesenteric ischemia (CMI); IMA Doppler; Mesenteric Doppler ultrasound; Mesenteric revascularization; Mesenteric stent; SMA Doppler.

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References

    1. Hansen KJ, Wilson DB, Craven TE, Pearce JD, English WP, Edwards MS, Ayerdi J, Burke GL (2004) Mesenteric artery disease in the elderly. J Vasc Surg 40 (1):45-52. https://doi.org/10.1016/j.jvs.2004.03.022 - DOI - PubMed
    1. Hohenwalter EJ (2009) Chronic mesenteric ischemia: diagnosis and treatment. Semin Intervent Radiol 26 (4):345-351. https://doi.org/10.1055/s-0029-1242198 - DOI - PubMed - PMC
    1. Zeller T, Rastan A, Sixt S (2010) Chronic atherosclerotic mesenteric ischemia (CMI). Vasc Med 15 (4):333-338. https://doi.org/10.1177/1358863X10372437 - DOI - PubMed
    1. Cunningham CG, Reilly LM, Stoney R (1992) Chronic visceral ischemia. Surg Clin North Am 72 (1):231-244 - DOI
    1. Ruzicka FF, Jr., Rossi P (1970) Normal vascular anatomy of the abdominal viscera. Radiol Clin North Am 8 (1):3-29 - PubMed

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