A novel concept on volumetric assessment and quantification of gastrointestinal bleed on computed tomography angiography: Observations based on a case series

Amritha, P P; Gadabanahalli, Karthik; Bhat, Venkatraman; Kumar, B N Kishore

doi:10.14701/ahbps.2021.25.1.160

Cited by 2 publications

(2 citation statements)

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“…Regarding GIB, in a series of three cases, P et al [ 38 ] described the potential of volumetric estimation of GIB on CTA for illustrative purposes rather than showing population-based results[ 38 ]. In another recent study exclusively focused on lower GIB[ 23 ], a similar semiautomatic dedicated software was adopted to determine the active hemorrhage size both with axial and volumetric measurements.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, there is still debate on safety and utility of empiric embolization regardless of positive catheter angiography, primarily in lower GIB. In this regard, the GIB volumetric assessment enhances the role of CTA in improving patient selection and risk stratification, to better identify which patients would mostly benefit from (target or prophylactic) TAE, avoiding the adjunctive risks of an invasive procedure[ 23 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

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Extravasated contrast volumetric assessment on computed tomography angiography in gastrointestinal bleeding: A useful predictor of positive angiographic findings

Cacioppa,

Floridi,

Bruno

et al. 2024

World J Radiol

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BACKGROUND Gastrointestinal bleeding (GIB) is a severe and potentially life-threatening condition, especially in cases of delayed treatment. Computed tomography angiography (CTA) plays a pivotal role in the early identification of upper and lower GIB and in the prompt treatment of the haemorrhage. AIM To determine whether a volumetric estimation of the extravasated contrast at CTA in GIB may be a predictor of subsequent positive angiographic findings. METHODS In this retrospective single-centre study, 35 patients (22 men; median age 69 years; range 16-92 years) admitted to our institution for active GIB detected at CTA and further submitted to catheter angiography between January 2018 and February 2022 were enrolled. Twenty-three (65.7%) patients underwent endoscopy before CTA. Bleeding volumetry was evaluated in both arterial and venous phases via a semi-automated dedicated software. Bleeding rate was obtained from volume change between the two phases and standardised for unit time. Patients were divided into two groups, according to the angiographic signs and their concordance with CTA. RESULTS Upper bleeding accounted for 42.9% and lower GIB for 57.1%. Mean haemoglobin value at the admission was 7.7 g/dL. A concordance between positive CTA and direct angiographic bleeding signs was found in 19 (54.3%) cases. Despite no significant differences in terms of bleeding volume in the arterial phase (0.55 mL vs 0.33 mL, P = 0.35), a statistically significant volume increase in the venous phase was identified in the group of patients with positive angiography (2.06 mL vs 0.9 mL, P = 0.02). In the latter patient group, a significant increase in bleeding rate was also detected (2.18 mL/min vs 0.19 mL/min, P = 0.02). CONCLUSION In GIB of any origin, extravasated contrast volumetric analysis at CTA could be a predictor of positive angiography and may help in avoiding further unnecessary procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%