CT Diagnosis and Applications of Acute Abdominal Vascular Disease

Objective: To review the CT manifestations, clinical features and ultrasonic results of patients with Acute abdominal vascular disease, and summarize the diagnostic experience to improve the diagnosis. Method: 156 cases with acute abdomen vascular disease of clinical data and imaging data underwent emergency abdominal CT examination in the emergency department of our hospital from January 2012 to March 2017, are analyzed retrospectively. According to the different types of vascular lesions and the different vessels involved, the cases are divided into five major types, and the number of cases, the typical CT image performance and the positive rate of ultrasound are analyzed respectively. Results: The classification as follows:(a) Arterial dissection and aneurysm (53 cases). Among them, there were 17 cases of arterial dissection, including 15 cases of thoracic aortic dissection downward continuation, 1 cases of limited dissection of the inferior segment of abdominal aorta, 1 cases of abdominal aortic dissection extending to the right iliac artery; and 36 cases of aneurysm:including 30 cases of abdominal aortic aneurysm, 3 cases of abdominal aorta pseudoaneurysm, 1 case of splenic artery pseudoaneurysm, 1 case of rupture of abdominal aortic aneurysm after stent implantation and 1 case of right iliac artery aneurysm. (b) Mesenteric vascular diseases (30 cases). Among them, there were 12 cases of superior mesenteric artery embolism, 1 cases of inferior mesenteric artery embolism, 15 cases of mesenteric vein embolism (including 5 cases with portal vein embolism), 1 case of superior mesenteric artery dissection and 1 cases of mesenteric artery intramural hematoma. (c) Portal vein system diseases (52 cases). Among them, there were 19 cases of portal hypertension, 17 cases of portal vein thrombosis, 9 cases of portal vein tumor thrombus, 3 cases of cavernous change of portal vein, and 4 cases of portal venous gas. (d) Spleen infarction or renal infarction (12 cases). e) Other types of acute abdominal vascular disease (9 cases). Conclusion: For acute abdominal vascular disease, enhanced CT has a greater advantage than plain CT and ultrasound. Different types of acute abdominal vascular disease have different typical CT manifestations. Both clinical and imaging doctors need to strengthen the recognition and attention to the disease, summarize the diagnostic experience, reduce misdiagnosis and misdiagnosis, and finally improve the level of diagnosis of this kind of disease.