Fig. 11
From: Vascular CT and MRI: a practical guide to imaging protocols
An 85-year-old woman developed severe abdominal pain two days post percutaneous aortic valve replacement and was referred for a CT mesenteric angiogram. Axial (a) and coronal (b) images from an arterial phase CT mesenteric angiogram demonstrate hypoenhancement of distal ileal loops (straight arrow) compared with adjacent proximal ileal and jejunal loops with normal mural enhancement (curved arrow). Axial (c) and coronal oblique images from the same study demonstrate focal occlusion of the mid-superior mesenteric artery with calcified plaque (arrow). Coronal oblique maximum intensity projection (MIP) reformat (d) is useful in demonstrating the point of SMA obstruction (arrow). Exploratory laparoscopy revealed extensive small bowel ischaemia, and the patient unfortunately expired