CTMesenterialangiografie

CT mesenteric angiography is a contrast-enhanced computed tomography study that focuses on the mesenteric arteries, including the celiac axis, superior mesenteric artery, and inferior mesenteric artery, to evaluate vascular anatomy, patency, and bowel perfusion. The examination provides high-resolution images with multiplanar reformats and 3D reconstructions to assess vessels and surrounding structures.

The protocol typically involves intravenous administration of iodinated contrast with imaging performed in the arterial phase to optimally visualize the mesenteric arteries. Modern multidetector CT scanners enable thin-slice acquisitions and rapid image capture, often followed by portal venous and/or delayed phases. Post-processing tools such as maximum intensity projections and volume-rendered images aid in the interpretation. The study may be combined with CT enterography to assess bowel wall and adjacent pathology when indicated.

Indications for CT mesenteric angiography include suspected acute mesenteric ischemia in the setting of abdominal pain, suspicion of chronic mesenteric ischemia due to visceral arterial stenosis, evaluation of vascular anomalies or aneurysms, assessment after trauma or vascular surgery, and preoperative planning for revascularization procedures. It can also aid in detecting occlusions, stenoses, occlusive thrombi, or collateral circulation and in evaluating bowel viability.

Interpretation revolves around the patency and course of the major mesenteric vessels, presence of stenosis or occlusion, vessel aneurysms, and signs of bowel ischemia such as perfusion deficit, bowel wall thickening, or pneumatosis. Limitations include radiation exposure, nephrotoxicity from iodinated contrast, and contraindications in patients with contrast allergy or unstable hemodynamics.