Seven-Tesla micro-MRI in early detection of acute arterial ischaemia: evolution of findings in an in vivo rat model

Berritto, Daniela; Somma, Francesco; Cavaliere, Carlo; Corona, Mario; Russo, S; Fulciniti, Franco; Cappabianca, Salvatore; Rotondò, Antonio; Grassi, Roberto

doi:10.1007/s11547-011-0676-7

Cited by 27 publications

(25 citation statements)

References 27 publications

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“…Thanks to the development of animal model of mesenteric ischemia, it was possible to explore the physiopathological process that conducts to intestinal infarction, underlining that a specific timing of lesions occurs and it is very important to define this to ensure a correct diagnostic assessment and therapeutic result [27]. …”

Section: Resultsmentioning

confidence: 99%

Mesenteric ischemia: the importance of differential diagnosis for the surgeon

et al. 2013

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BackgroundIntestinal ischemia is an abdominal emergency that accounts for approximately 2% of gastrointestinal illnesses. It represents a complex of diseases caused by impaired blood perfusion to the small and/or large bowel including acute arterial mesenteric ischemia (AAMI), acute venous mesenteric ischemia (AVMI), non occlusive mesenteric ischemia (NOMI), ischemia/reperfusion injury (I/R), ischemic colitis (IC). In this study different study methods (US, CT) will be correlated in the detection of mesenteric ischemia imaging findings due to various etiologies.MethodsBasing on our institutions experience, 163 cases of mesenteric ischemia/infarction from various cases, investigated with CT and undergone surgical treatment were retrospectively evaluated, in particular trought the following findings: presence/absence of arterial/venous obstruction, bowel wall thickness and enhancement, presence/absence of spastic reflex ileus, hypotonic reflex ileus or paralitic ileus, mural and/or portal/mesenteric pneumatosis, abdominal free fluid, parenchymal ischemia/infarction (liver, kidney, spleen).ResultsTo make an early diagnosis useful to ensure a correct therapeutic approach, it is very important to differentiate between occlusive (arterial, venous) and non occlusive causes (NOMI). The typical findings of each forms of mesenteric ischemia are explained in the text.ConclusionThe radiological findings of mesenteric ischemia have different course in case of different etiology. In venous etiology the progression of damage results faster than arterial even if the symptomatology is less acute; bowel wall thickening is an early finding and easy to detect, simplifying the diagnosis. In arterial etiology the damage progression is slower than in venous ischemia, bowel wall thinning is typical but difficult to recognize so diagnosis may be hard. In the NOMI before/without reperfusion the ischemic damage is similar to AAMI with additional involvement of large bowel parenchymatous organs. In reperfusion after NOMI and after AAMI the CT and surgical findings are similar to those of AVMI, and the injured bowel results quite easy to identify. The prompt recognition of each condition is essential to ensure a successful treatment.

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Section: Resultsmentioning

confidence: 99%

Mesenteric ischemia: the importance of differential diagnosis for the surgeon

et al. 2013

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“…In CP, pericolic fluid was never found; in the injured colonic wall, fibrotic reaction develops leading to continuous mild and irregular circumferential thickening with gaping lumen [18, 19], as observed in 100% of patients, and so, the target sign, due to acute mucosal hemorrhagic and edematous phenomena, is absent (Figure 5). …”

Section: Discussionmentioning

confidence: 99%

“…Recently, investigations have suggested that magnetic resonance imaging (MRI) could play an important role especially in the follow-up of IC [15–17]. Considering previous experiences on animal models in which the correct evolution of the small and the large bowel ischemia/infarction was studied and defined [16, 18, 19], a similar evolution of IC can then be expected in humans in which the spectrum of findings remains currently not well understood [20]. …”

Section: Introductionmentioning

confidence: 99%

CT Findings in Acute, Subacute, and Chronic Ischemic Colitis: Suggestions for Diagnosis

Iacobellis

Berritto

Fleischmann

et al. 2014

BioMed Research International

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Purpose. This paper aims at evaluating CT findings of occlusive and nonocclusive ischemic colitis (IC), in correlation with the etiology and the different phases of the disease. Materials and Methods. CT examination and clinical history of 32 patients with proven IC were retrospectively reviewed. The CT findings were analyzed according to the different phases of the disease (acute, subacute, and chronic). Results. Among the 32 CT examinations performed in the acute phase, 62.5% did not present signs of occlusion of the superior mesenteric artery (SMA) or inferior mesenteric artery (IMA), whereas IMA occlusion was detected in 37.5% of CT examinations. In the acute phase, the presence of pericolic fluid was found in 100% of patients undergoing progressive resorption from acute to subacute phase if an effective reperfusion occurred; the bowel wall thickening was observed in 28.1% patients in acute phase and in 86.4% patients evaluated in subacute phase. The unthickened colonic wall was found in all conditions where ischemia was not followed by effective reperfusion (71.9% of cases), and it was never found in chronic phase, when the colon appeared irregularly thickened. Conclusion. CT allows determining the morphofunctional alterations associated with the IC discriminating the occlusive forms from the nonocclusive forms. CT, furthermore, allows estimating the timing of ischemic damage.

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“…While radiologist are usually familiar with the more common imaging including radiographs, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound (US) procedures, many are not aware of the significant contributions nuclear medicine can make in the management of patients in acute care [1][2][3][4][5][6][7]. While other radiologic imaging methods depict anatomy and rely on knowledge of normal patterns to recognize abnormal ones, nuclear medicine evaluates organ and physiologic functions.…”

Section: Introductionmentioning

confidence: 99%

Nuclear medicine and the emergency department patient: an illustrative case-based approach

et al. 2014

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Radiologists are familiar with the use of radiographs, computed tomography, magnetic resonance imaging and ultrasound in the acute clinical setting. However, there are some specific clinical scenarios which may be found in nuclear medicine imaging problem-solving tools. These clinical scenarios and imaging techniques are less frequent, and the referring clinician from the emergency department may not consider these alternatives. It is important for the radiologist to be aware of these techniques to be able to guide the clinician to use those tools, which may result in optimal patient care. In this article, we will discuss those nuclear medicine studies which have application in the setting of an emergency radiology practice.

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Seven-Tesla micro-MRI in early detection of acute arterial ischaemia: evolution of findings in an in vivo rat model

Abstract: This model shows the correct sequence of events during arterial AMI and demonstrates that MRI can be recommended for early diagnosis of these lesions.

Cited by 27 publications

References 27 publications

Mesenteric ischemia: the importance of differential diagnosis for the surgeon

Mesenteric ischemia: the importance of differential diagnosis for the surgeon

CT Findings in Acute, Subacute, and Chronic Ischemic Colitis: Suggestions for Diagnosis

Nuclear medicine and the emergency department patient: an illustrative case-based approach

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