Purpose: The aim of the present study is to evaluate the feasibility of multislice computed tomography (MSCT) angiography of the celiac and superior mesenteric arteries with a non tailored protocol. Sixteen patients underwent both MSCT of the upper abdomen and digital subtraction celiac and superior mesenteric angiography. CT examinations included unenhanced scanning and dual-phase (arterial and portal) scanning of the upper abdomen. Retrospective 2.5 mm thick slices with 50% overlap were used for CT angiography reformations with volume rendering (VR), high density maximum intensity projection (HD-MIP) and subvolume MIP technique; normal arterial anatomy, variants, stenoses and aneurysms were assessed and compared with findings of digital subtraction angiography.
Results: All VR and HD-MIP reconstructions were considered satisfactory, except in two cases because of inappropriate setting of scan parameters; subvolume MIP reformations were considered satisfactory in all cases, and superior in the depiction of small arteries. Aneurysms and stenoses were always detected, whereas a case of replaced right hepatic artery in a patient with complex vascular anatomy was misdiagnosed by MSCT angiography. The overall accuracy of VR, HD-MIP and MIP CT angiographic reconstructions was 71.9%, 81.8% and 94.6%, respectively.
Conclusions: In our preliminary report, CT angiography with multidetector CT has proved effective in depicting splanchnic arterial anatomy, and can replace diagnostic invasive angiography in most cases. Good quality of axial images is necessary for reformations with VR and MIP techniques.