CT Imaging of Acute Bowel Ischemia and Infarction - Department of ...
CT Imaging of Acute Bowel Ischemia and Infarction - Department of ... CT Imaging of Acute Bowel Ischemia and Infarction - Department of ...
Pathology Etiologies: Non-occlusive Lupus
CT Technique: Ischemic Bowel Protocol 3 Types of contrast (a) IV (150 cc via mechanical injector at a rate of 2-4 ml/sec) (b) Oral (c) Rectal NB: Bowel distension (i.e. assess bowel wall thickness) NB: Positive vs. negative contrast Positive contrast indicated in suspected bowel obstruction and advantageous for delineation of inner mural layer in setting of hypoattenuating mucosa. Otherwise, negative contrast allows optimal delineation of mural layers. 3 Phases (a) Unenhanced •Differentiating hyperattenuating bowel wall caused by hemorrhage from that caused by hyperperfusion •Background atherosclerotic disease •Hyperattenuating intravascular clot (b) Arterial (30 sec) •Arterial occlusion (c) Portovenous (90 sec) •Venous occlusion •Assessment of the remainder of the organs Triple contrast Triple phased Triple planar 3 Planes (a) Axial (b) Coronal (c) Sagittal
- Page 1 and 2: CT Imaging of Acute Bowel Ischemia
- Page 3 and 4: Anatomy Vascular Supply of Bowel: A
- Page 5 and 6: Anatomy Vascular Supply of Bowel: V
- Page 7 and 8: Pathology Ischemia and Infarction:
- Page 9 and 10: Pathology Etiologies 1. Occlusive (
- Page 11 and 12: Pathology Etiologies: Occlusive SMA
- Page 13 and 14: Pathology Etiologies: Occlusive Aor
- Page 15: Pathology Etiologies: Non-occlusive
- Page 19 and 20: CT Findings: Approach • Distribut
- Page 21 and 22: CT Findings: Bowel Thickening • s
- Page 23 and 24: CT Findings: Fluid • (a) Fat stra
- Page 25 and 26: CT Findings: Air Pneumotosis Portal
- Page 27 and 28: CT Findings: Complications • Perf
- Page 29 and 30: Cases Case #1: Large bowel ischemia
- Page 31 and 32: Cases Case #2: Large bowel ischemia
- Page 33 and 34: Cases Case #3: Small bowel Ischemia
- Page 35 and 36: Cases Case #4: Small and large bowe
- Page 37 and 38: Cases Case #5: Small bowel obstruct
- Page 39: Cases 1. 2678623 = large bowel isch
<strong>CT</strong><br />
Technique: Ischemic <strong>Bowel</strong> Protocol<br />
3 Types <strong>of</strong> contrast<br />
(a) IV (150 cc via mechanical injector at a rate <strong>of</strong> 2-4 ml/sec)<br />
(b) Oral<br />
(c) Rectal<br />
NB: <strong>Bowel</strong> distension (i.e. assess bowel wall thickness)<br />
NB: Positive vs. negative contrast Positive contrast indicated in suspected bowel obstruction <strong>and</strong> advantageous for delineation <strong>of</strong><br />
inner mural layer in setting <strong>of</strong> hypoattenuating mucosa. Otherwise, negative contrast allows optimal delineation <strong>of</strong> mural layers.<br />
3 Phases<br />
(a) Unenhanced<br />
•Differentiating hyperattenuating bowel wall caused by hemorrhage from that caused by hyperperfusion<br />
•Background atherosclerotic disease<br />
•Hyperattenuating intravascular clot<br />
(b) Arterial (30 sec)<br />
•Arterial occlusion<br />
(c) Portovenous (90 sec)<br />
•Venous occlusion<br />
•Assessment <strong>of</strong> the remainder <strong>of</strong> the organs<br />
Triple contrast<br />
Triple phased<br />
Triple planar<br />
3 Planes<br />
(a) Axial<br />
(b) Coronal<br />
(c) Sagittal
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