Background

Non-occlusive mesenteric ischemia (NOMI) is a mesenteric ischemic disease with considerably high mortality rate, although little has been known about what factors affect the patients’ prognosis. The purpose of this study was to investigate prognostic factors of clinical data and computed tomography (CT) findings in patients with NOMI.

Methods

This was a single institutional, retrospective study, reviewing 21 consecutive patients diagnosed with NOMI on angiography. Patients were divided into either ‘‘survivor’’ group or ‘‘non-survivor’’ group based on their clinical courses 1 month after diagnosis. Clinical information such as laboratory data, Charlson Comorbidity Index, and time from CT to injecting vasodilator was obtained from patients’ medical records. Contrast-enhanced CT images were assessed in following items: defect of mural enhancement, pneumatosis intestinalis, hepatic portal venous gas, paralytic bowel dilatation, bowel wall thinning, and diameters of the relevant vessels.

Results

Eight patients belonged to ‘‘survivor’’ group, whereas eleven were allocated to ‘‘non-survivor’’ group. None of CT findings showed significant difference between survivor group and non-survivor group [defect of mural enhancement: 75% and 100% (p = 0.16), pneumatosis intestinalis: 50% and 45.5% (p = 1.00), hepatic portal venous gas: 37.5% and 45.5% (p = 1.00), paralytic bowel dilatation: 12.5% and 63.6% (p = 0.06), and bowel wall thinning: 50% and 45.5% (p = 1.00)]. The diameters of the relevant vessels did not have significant difference either. Time from CT to injecting vasodilator was revealed to be significantly shorter in survivor group [187.5 (122.5–294) min and 310 (187–925.5)] (p = 0.048). None of the other clinical information had significant difference between each group.

Conclusion

Prompt angiography may be a key to improve the prognosis of NOMI patients.

中文翻译：

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什么会影响NOMI患者的预后？临床数据和CT检查结果分析

背景

非阻塞性肠系膜缺血（NOMI）是一种具有很高死亡率的肠系膜缺血疾病，尽管对影响患者预后的因素知之甚少。这项研究的目的是调查NOMI患者的临床数据和计算机断层扫描（CT）结果的预后因素。

方法

这是一项单一的机构回顾性研究，回顾了连续21例经血管造影诊断为NOMI的患者。根据诊断后1个月的临床病程，将患者分为“幸存者”组或“非幸存者”组。从患者的病历中获取临床信息，例如实验室数据，Charlson合并症指数以及从CT到注射血管扩张剂的时间。在以下项目中评估了增强的CT图像：壁增生缺损，肠尘肺，肝门静脉气体，麻痹性肠扩张，肠壁变薄以及相关血管的直径。

结果

8名患者属于“幸存者”组，而11名患者被分配为“非幸存者”组。CT结果均未显示幸存者组与非幸存者组之间有显着性差异[壁膜增高的缺陷：75％和100％（p  = 0.16），肠气肿：50％和45.5％（p  = 1.00），肝门静脉气体：37.5％和45.5％（p ＝ 1.00），麻痹性肠扩张：12.5％和63.6％（p ＝ 0.06），肠壁变薄：50％和45.5％（p ＝ 1.00）]。相关血管的直径也没有显着差异。在幸存者组中，从CT到注射血管舒张剂的时间显着缩短[187.5（122.5–294）分钟和310（187–925.5）分钟]（p = 0.048）。每组之间其他临床信息均无显着差异。

结论

及时的血管造影可能是改善NOMI患者预后的关键。