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CTA Mesenteric Ischemia

Last Updated: 2026-01-01 Author:

  • 1. Clinical Summary

    Series Phase Coverage
    Non-contrast N/A Diaphragm to Lesser Trochanters
    Arterial Phase Contrast (25 sec delay) Diaphragm to Lesser Trochanters
    Portal Venous Contrast (70 sec delay) Diaphragm to Lesser Trochanters
    • Acute mesenteric ischemia
    • Chronic mesenteric ischemia
    • Bowel infarction

  • 2. Patient Prep

    • Position: Supine with arms raised
    • NPO Status: NPO (emergent - as patient presents)
    • Pre-Medication:
      • None - emergent study

  • 3. IV Contrast & Injection

    Parameter Value
    Agent Isovue 370
    Volume 1.5 mL/kg
    Flow Rate 5 mL/s
    Duration 20s
    Timing Method Dual phase: Arterial + Portal Venous
    ROI Placement Abdominal aorta at celiac
    Trigger (HU) 150 HU

    Use full dose if GFR > 30

    If GFR < 30

    Max Contrast = \(2*\left[\frac{\text{Patient Weight}}{75 \text{ kg}} * \text{eGFR}\right]\)

  • 4. Special Notes

    • Arterial phase at 25 sec for vessel assessment. Portal venous at 70 sec for bowel perfusion. High flow rate critical
    • Additional Recons: MIP and 3D VR of celiac and SMA. Curved MPR of vessels
    • 18-20G IV required for 5 mL/s flow. Must be patent

    Safety First

    • Renal Function: eGFR > 30 preferred
    • Allergy: Emergency study - document indication
    • Arterial: assess celiac SMA IMA origins. Portal: look for bowel wall enhancement. Check for pneumatosis
    • Fast scan. High flow rate essential
Series Name Start Location End Location Delay Slice Thickness Notes
Scout/Topogram Diaphragm Pubic symphysis N/A N/A AP
Arterial Phase Diaphragm Iliac crests 25 sec 0.625 mm Focus on celiac SMA IMA
Portal Venous Diaphragm Pubic symphysis 70 sec 0.625 mm Assess bowel wall enhancement
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial Arterial Abdomen 2 mm/2 mm Vascular 3 Mesenteric vessel origins
Axial Portal venous Full AP 2.5 mm/2.5 mm Standard 3 Bowel wall assessment
Coronal Arterial Abdomen 2.5 mm/2.5 mm Vascular 3 MIP of mesenteric vessels
Sagittal Arterial Abdomen 2.5 mm/2.5 mm Vascular 3 Curved MPR SMA from origin