Splanchnic Arterial Stenosis or Occlusion

http://radiology.rsna.org/content/211/2/405.full

Hyo K. Lim, MD ; Won J. Lee, MD ; Seung H. Kim, MD ; Soon J. Lee, MD ; Sang H. Choi, MD ; Hong S. Park, MD ; Young S. Do, MD ; Sung W. Choo, MD ; In W. Choo, MD

1 From the Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul, Korea 135-710. From the 1996 RSNA scientific assembly. Received May 20, 1998; revision requested July 14; revision received August 25; accepted November 20. Address reprint requests to H.K.L.

PURPOSE: To determine the diagnostic accuracy of Doppler ultrasonography (US) in the detection of high-grade stenosis or occlusion of the celiac artery (CA) and superior mesenteric artery (SMA) and validate the previously reported Doppler US criteria.

MATERIALS AND METHODS: During a recent 36-month period, 82 patients were prospectively examined with Doppler US of the splanchnic arteries and with lateral abdominal aortography, regardless of their abdominal symptoms. The previously reported diagnostic criteria with the fasting peak systolic velocity measurement were prospectively used in all patients. The results of Doppler US were compared with those of lateral aortography.

RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Doppler US for the detection of 70% or greater CA stenosis or occlusion were 100%, 87%, 57%, 100%, and 89%, respectively; for 70% or greater SMA stenosis or occlusion, these values were 100%, 98%, 93%, 100%, and 99%, respectively.

CONCLUSION: Owing to its high accuracy in the diagnosis of high-grade splanchnic arterial stenosis or occlusion, Doppler US can be used as a screening method to help detect CA or SMA stenosis or occlusion and can reduce the use of unnecessary, invasive angiography.