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Abdominal Radiology

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01-10-2020 | Visceral Ischemia | Review

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

Authors: Margarita V. Revzin, John S. Pellerito, Nariman Nezami, Mariam Moshiri

Published in: Abdominal Radiology | Issue 10/2020

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.

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Title: The radiologist’s guide to duplex ultrasound assessment of chronic mesenteric ischemia
Authors: Margarita V. Revzin
John S. Pellerito
Nariman Nezami
Mariam Moshiri
Publication date: 01-10-2020
Publisher: Springer US
Keywords: Visceral Ischemia
Ultrasound
Mesenteric Artery Stenosis
Ultrasound
Published in: Abdominal Radiology / Issue 10/2020
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-019-02165-2

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