American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the preferred diagnostic method for chronic mesenteric ischemia?

1. Magnetic resonance angiography

2. CT angiography

3. Selective venography

4. Ultrasound Doppler study

The correct answer is: CT angiography

The preferred diagnostic method for chronic mesenteric ischemia is CT angiography. This imaging technique is highly favored because it provides rapid, detailed visualization of the mesenteric arteries and can evaluate the presence, location, and extent of vascular stenosis or occlusion. CT angiography is non-invasive and allows for the assessment of abdominal organs simultaneously, which can be crucial in understanding whether other anatomical factors contribute to a patient's symptoms. Additionally, it can help differentiate between chronic ischemia and other potential causes of abdominal pain by providing information about perfusion and collateral circulation. While other modalities such as magnetic resonance angiography and ultrasound Doppler studies can be useful in certain contexts, they may not offer the same level of detail or speed as CT angiography. Selective venography, which focuses primarily on venous structures, is not generally used for diagnosing mesenteric ischemia since this condition primarily concerns the arterial supply. Thus, the effectiveness, speed, and comprehensive nature of CT angiography make it the diagnostic method of choice for assessing chronic mesenteric ischemia.