Diagnosis of spontaneous isolated superior mesenteric artery dissection using computed tomography angiography / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of the spontaneous isolated superior mesenteric artery dissection (SISMAD) on computed tomography angiography (CTA).</p><p><b>METHODS</b>Twenty-five patients with unexplained acute abdominal pain received CTA.</p><p><b>RESULTS</b>Four cases with the SISMAD were found and all were male with a mean age of (45.3±6.7) years. Two patients had hypertension history. CT showed enlarged diameter of the superior mesenteric artery with dissection in 4 cases, intimal flap and visible false lumen in 2 cases, ulcer-like laceration in 1 case, and intramural hematoma in 1 case. The proximal lacerations or entries were all at the proximal segment of the superior mesenteric artery. CTA classifications were type Ia (n=2), IIb (n=1), and III (n=1). Two patients underwent repeated CTA when discharged, and progressive changes were discovered.</p><p><b>CONCLUSION</b>CTA can clearly show the characteristics of the superior mesenteric artery dissection, confirm the diagnosis, and provide an important basis for the classification and follow-up observation.</p>

Value of diffusion-weighted magnetic resonance imaging of the thrombi in the cerebral venous sinuses during thrombolytic therapy / 中华神经医学杂志

Objective To investigate diffusion-weighted(DWI)magnetic resonance imaging (MRI) features of the thrombi in patients with cerebral sinus thrombosis(CST),and explore their relation with the recanalization rate alter thrombolytic therapy. Methods The clinical and imaging data were retrospectively analyzed in 14 CST cases,including conventional MRI,FLAIR,DWI and MRV features.The hyperintense signals on DWI at the site ofvenous occlusion were analyzed,and MRV was performed 1-3 months after the thrombolytic therapy to assess the recanalization.The relation between the findings by T1WI,FLAIR and DWI before the thrombolytic therapy and the recanalization rate after the therapy was evaluated.Results Hyperintense signals Was detected in 21 occluded sinuses in 9 patients(41%)with a recellt CVT.Hyperintense signals in the thrombi on the initial MRl were associated with a significantly lowered rate of complete recanalization of the vessel as compared with that among cases without the hyperintense signals(19.0%vs 68.2%,P=0.005). Conclusion The DWI signals of the thrombi in the cerebral venous sinuses can be associated with the progression of the thrombosis,and the presence of hyperintense signals in the occluded cerebral sinuses on the initial DWI may suggest a low rate of sinus recanalization after 1 t0 3 months of thrombolytic therapy.