CT angiography features of the involved arterial branches of the spontaneous isolated superior mesenteric artery dissection

Abstract

To explore the CT angiography features of the involved arterial branches of the spontaneous isolated superior mesentery artery dissection(SISMAD). Clinical and CT angiogram data of 6 patients with SISMAD confirmed by dual source energy CT angiography were analyzed retrospectively. The CT angiography features and prognosis of patients were investigated. Average age of 6 patients was(45.83±5.60) years old. Ten branches of jejunoileal artery were involved in 4 patients. All the dissections of the superior mesenteric arteries(SMA) were extended from its proximal to its end. Intramural hematoma was found in all the involved branches, which showed eccentric target sign in the transverse section and sandwich sign in the longitudinal axial section. In 7 branches of 3 patients, the involved branches originated from the false lumina of the SMA. In one patient, the intramural hematoma of the jejunoileal arteries was found to be completely absorbed in a repeated CT angiography one year late. For the SISMAD, the involvement of the branches of the SMA may be associated with the extension of the dissection of the SMA. The inflation of the false lumina of the branches is worse than that of the SMA. With the improvement of the dissection of the SMA, the intramural hematoma of the branches can be absorbed. The conservative treatment may be the first choice for SISMAD without emergency.