Brief Article
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World J Gastroenterol. Oct 28, 2013; 19(40): 6825-6833
Published online Oct 28, 2013. doi: 10.3748/wjg.v19.i40.6825
Acute arterial mesenteric ischemia and reperfusion: Macroscopic and MRI findings, preliminary report
Luca Saba, Daniela Berritto, Francesca Iacobellis, Mariano Scaglione, Sigismondo Castaldo, Santolo Cozzolino, Maria Antonietta Mazzei, Veronica Di Mizio, Roberto Grassi
Luca Saba, Department of Radiology, Azienda Ospedaliera Universitaria di Cagliari, 09045 Cagliari, Italy
Daniela Berritto, Francesca Iacobellis, Roberto Grassi, Institute of Radiology, Second University of Naples, 80138 Napoli, Italy
Mariano Scaglione, Department of Diagnostic Imaging, Clinical Institute Pineta Grande, 81030 Castel Volturno Caserta, Italy
Mariano Scaglione, Department of Radiology, The Royal London Hospital, London E1 1BB, United Kingdom
Sigismondo Castaldo, Santolo Cozzolino, Biotechnology Centre, 80131 Napoli, Italy
Maria Antonietta Mazzei, Department of Surgical Sciences, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy
Veronica Di Mizio, Department of Radiology, Santa Maria della Misericordia Hospital, 45100 Rovigo, Italy
Author contributions: Saba L partecipated to the conception and design of the study and wrote the manuscript; Berritto D and Iacobellis F performed the research, contributed to the conception and design of the study and to the acquisition and interpretation of the data; Castaldo S and Cozzolino S contributed to the acquisition of the data; Scaglione M, Mazzei MA and Di Mizio V critically revised the article for important intellectual content; Grassi R designed the research and approved the final version for publication.
Correspondence to: Daniela Berritto, MD, Institute of Radiology, Second University of Naples, P.za Miraglia 2, 80138 Napoli, Italy. berritto.daniela@gmail.com
Telephone: +39-81-5665203 Fax: +39-81-5665200
Received: June 3, 2013
Revised: July 27, 2013
Accepted: August 17, 2013
Published online: October 28, 2013
Processing time: 163 Days and 6.9 Hours
Abstract

AIM: To explore the physiopathology and magnetic resonance imaging (MRI) findings in an animal model of acute arterial mesenteric ischemia (AAMI) with and without reperfusion.

METHODS: In this study, 8 adult Sprague-Dawley rats underwent superior mesenteric artery (SMA) ligation and were then randomly divided in two groups of 4. In group I, the ischemia was maintained for 8 h. In group II, 1-h after SMA occlusion, the ligation was removed by cutting the thread fixed on the back of the animal, and reperfusion was monitored for 8 h. MRI was performed using a 7-T system.

RESULTS: We found that, in the case of AAMI without reperfusion, spastic reflex ileus, hypotonic reflex ileus, free abdominal fluid and bowel wall thinning are present from the second hour, and bowel wall hyperintensity in T2-W sequences are present from the fourth hour. The reperfusion model shows the presence of early bowel wall hyperintensity in T2-W sequences after 1 h and bowel wall thickening from the second hour.

CONCLUSION: Our study has shown that MRI can assess pathological changes that occur in the small bowel and distinguish between the presence and absence of reperfusion after induced acute arterial ischemia.

Keywords: Acute arterial mesenteric ischemia; Reperfusion; Magnetic resonance imaging; Animal model; Superior mesenteric artery; Bowel ischemia

Core tip: Diagnosis of acute arterial mesenteric ischemia depends on early detection and findings with regarding the presence or absence of reperfusion events. Distinguishing between these different conditions is crucial to improving outcome for the patient and represents a challenge for radiologists. The results of this preliminary study in an animal model provide for a time-based definition of the radiological findings in ischemia and reperfusion, showing that magnetic resonance imaging can adequately assess the different pathological changes that occur in acute arterial mesenteric ischemia with or without reperfusion.