What Is the Most Sensitive and Specific Imaging Study for the Detection of Acute Mesenteric Ischemia? Is MDCT the Gold Standard?
Courtney H. McKee, Sarah E Ronan-Bentle
Angiography has traditionally been considered the gold standard test for diagnosis of acute mesenteric ischemia (AMI). Angiography is not only diagnostic but allows for immediate therapeutic interventions to achieve revascularization. However, computed tomography angiography (CTA) has now replaced angiography as the first-line diagnostic test for AMI. CTA is accurate and has excellent sensitivity and specificity, approaching 100%. It is fast and nearly universally available. Multiple studies and expert guidelines cite CTA as the test of choice for the diagnosis of AMI in the emergency department. Magnetic resonance angiography (MRA) does have a role, but the delay in diagnosis and lack of universal availability make it a less favorable diagnostic tool when compared to CTA.