Objective: The diagnosis of chronic mesenteric ischemia (CMI) is a clinical diagnosis of symptoms in setting of occlusive arterial disease.The study aimed to determine the predictive value of post-prandial superior mesenteric vein (SMV) flow augmentation on 2D phase contrast magnetic resonance imaging (2D PC-MR) as a measure of impaired perfusion in patients with suspected CMI.Methods: A retrospective review of all adult patients undergoing evaluation for CMI with 2D PC-MR at a single tertiary university care center between January 1, 2021 and January 1, 2025 was performed.Patients required one symptom (post-prandial pain, weight loss, food fear) and anatomic disease consistent with CMI (isolated severe SMA stenosis or occlusion, or at least moderate two vessel-visceral disease including the SMA).A threshold of post-prandial SMV J o u r n a l P r e -p r o o f flow augmentation less than 50% was chosen to represent abnormal physiologic response.The diagnosis of CMI was determined by a vascular surgeon.Descriptive statistics and contingency analysis were applied due to the small sample size.Results: 33 patients were included in the study.2D PC-MR demonstrated a sensitivity of 93% and a specificity of 68%.Positive predictive value was 68% and negative predictive value was 93%.Of the 3 patients diagnosed with CMI who underwent intervention and received a postprocedure 2D PC-MR study, all demonstrated symptom resolution and normalization of postprandial SMV flow augmentation.Conclusion: A threshold of post-prandial SMV flow augmentation less than 50% on 2D PC-MR was sensitive in detecting patients with CMI and demonstrated a good negative predictive value, suggesting it may be used as a screening tool in future.
Jones et al. (Fri,) studied this question.