The Role of Noninvasive Vascular Imaging in Splanchnic and Mesenteric Pathology

Traditionally, catheter angiography (CA) has been the mainstay of diagnosis for mesenteric arterial diseases. However, CA is invasive and is associated with complications that result from the procedure itself, depending on the experience of the operators, site of vascular access, ionized radiation that could be significant when combined with interventional procedures, and administered contrast material. During the past 2 decades, technical improvements in computed tomography (CT) and magnetic resonance hardware and methods have contributed new, noninvasive tools, specifically CT angiography (CTA) and 3-dimensional gadolinium-enhanced magnetic resonance angiography (3D Gd-MRA). This article outlines the current applications, strengths, and weaknesses of CTA and 3D Gd-MRA in imaging of the mesenteric vessels.

Abbreviations used in this paper: AMI, acute mesenteric ischemia, APF, arterioportal fistula, CA, catheter angiography, CMI, chronic mesenteric ischemia, CT, computed tomography, CTA, computed tomographic angiography, MDCT, multi-detector computed tomography, MIP, maximum intensity projection, SMA, superior mesenteric artery, SMV, superior mesenteric vein, 3D Gd-MRA, three-dimensional gadolinium-enhanced magnetic resonance angiography, US, ultrasonography, VAA, visceral artery aneurysm, VR, volume rendering