Dear Colleagues,

In the last three decades, the use of Computed Tomography (CT) has deeply changed the traditional paradigm of clinical diagnosis in Medicine, shifting from the classical physical point of view to a CT-guided approach. The impact of CT on morbidity, mortality, prognosis, costs and length of hospitalization has been tremendous in very different fields, including both emergency and non-emergency settings, improved cancer diagnosis, response to therapy, pre- and post-procedural assessment, helping preparation for surgeries or guiding the surgeons’ hands using a tailored operative or non-invasive approach. Advances in CT scan technology in recent years include reducing harmful radiation to patients and the development of iterative reconstruction, enabling for faster scan speed, as well as improved image quality and multiple post-processing possibilities. Actually, the increased speed of scanning enables physicians to provide more accurate diagnosis and better treatment for early or advanced coronary artery disease, which is a relatively new field of application of this technology. Spectral CT technology—also called dual-source or dual-energy CT—is actually becoming more and more relevant in clinical practice, thus creating contrast and non-contrast images from one single scan.

We welcome all colleagues to provide articles that explore modern CT technology from within their own fields.

Prof. Dr. Mariano Scaglione
Dr. Stefania Tamburrini
Guest Editors

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Title: Imaging of Intestinal Ischemia
Authors: Francesco Ronza; Stefania Tamburrini; Mariano Scaglione
Affiliation: AORN Ospedali dei Colli, Naples, Italy
Abstract: Intestinal ischemia diagnosis is challenging because non-specific clinical presentation and a prompt diagnosis is required to improve outcome. Multi Detector CT Angiography (MDCTA) is the first line investigation for the suspected diagnosis of vascular abdominal pathologies. MDCTA can accurately detect the presence of arterial and venous thrombosis, determine the extension and the gastrointestinal tract involved, provide detailed information to guide the management. Moreover, CT can differentiate forms that are still susceptible of pharmacological or interventional treatment (NOM= non operative management)form advanced disease with transmural necrosis in which surgical approach is required. The advent of Dual Source CT enriches diagnostic potentials of CT, increasing diagnostic confidence and providing important information of bowel parietal perfusion. CT imaging patterns and allow the diagnosis of the subtype and the extension and stage of intestinal ischemia. Knowledge of CT imaging patterns and corresponding vascular pathways is mandatory in Emergency settings to reach a prompt and accurate diagnosis. The aim of this paper is 1. to provide technical information about the optimal CTA protocol and to underline common pitfalls that may be encountered, 2. To empathize the CTA arterial and venous supply to gastrointestinal tract and relative ischemic pattern, 3. To underline CTA prognostic findings and stage’s disease that support clinicians, interventional radiology