Abstract
AimsThe smaller superior mesenteric vein (SMV) sign is a well‐known computed tomography (CT) parameter for acute superior mesenteric artery (SMA) occlusion. This CT sign is potentially beneficial for the early diagnosis of acute SMA occlusion; however, few reports have documented this sign. The present study aimed to determine the accuracy of the smaller SMV sign for the detection of acute SMA occlusion.MethodsWe retrospectively reviewed CT images from 20 patients with acute SMA occlusion and 1,216 controls. We measured the external diameters of the SMV and SMA, and calculated the SMV/SMA diameter ratio. A ratio ≤1 indicated a positive smaller SMV sign.ResultsOf the 20 patients, 14 had the smaller SMV sign, whereas of the 1,216 controls, 88 had the smaller SMV sign. Of the 88 controls with a positive sign, 79 had apparent reasons for the decreased flow in the SMA and nine patients had no reason for the decreased flow. The sensitivity and specificity of the smaller SMV sign for acute SMA occlusion were 70% and 99.2%, respectively.ConclusionThe smaller SMV sign is an accurate and important CT parameter for the detection of acute SMA occlusion.
Highlights
A CUTE SUPERIOR MESENTERIC artery (SMA) occlusion is rare, and accounts for less than 1 of every 1,000 hospitalizations
Mogi class A occlusion was present in 17 patients; of these, 12 had a smaller superior mesenteric vein (SMV) sign
Class B occlusion was present in two patients, and one had a smaller SMV sign
Summary
A CUTE SUPERIOR MESENTERIC artery (SMA) occlusion is rare, and accounts for less than 1 of every 1,000 hospitalizations. For the diagnosis of acute SMA occlusion, imaging techniques, such as ultrasonography, computed tomographic angiography (CTA), and magnetic resonance angiography, are useful.[1,3,4] each of these methods has limitations. Ultrasonography is highly dependent on the skill of the technologist, and it can be difficult to carry out in patients with obesity, bowel gas, and heavy calcification in the vessels. Computed tomographic angiography has a high accuracy for the diagnosis of SMA occlusion (up to 95– 100%). There might be issues with the use of contrast agents.[5,6] Magnetic resonance angiography requires a long time for imaging.[1] a quick and accurate diagnostic indicator for acute SMA occlusion is required. The smaller superior mesenteric vein (SMV) sign has been often discussed in textbooks.[7]
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