What is the gold standard for diagnosing intestinal ischemia?

The gold standard for diagnosing intestinal ischemia is angiography. This procedure allows for direct visualization of blood vessels and can reveal occlusions, stenoses, or other pathological changes affecting the mesenteric arteries. During angiography, a contrast dye is injected into the vascular system, and X-ray imaging captures the flow of the dye, highlighting areas where blood supply is compromised. This provides crucial information for diagnosing and determining the severity of intestinal ischemia.

While other imaging modalities such as CT angiography and magnetic resonance angiography can provide useful information and are less invasive, they do not offer the same level of detail regarding blood flow dynamics that traditional angiography provides. Ultrasound Doppler can assess blood flow and assist in evaluating conditions like bowel perfusion, but it lacks the specificity and detailed vascular mapping capability that angiography offers in cases of suspected intestinal ischemia.