HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Zink, S. I. Articles by Tubbs, D. S. Search for Related Content PubMed PubMed Citation Articles by Zink, S. I. Articles by Tubbs, D. S. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Noninvasive Evaluation of Active Lower Gastrointestinal Bleeding: Comparison Between Contrast-Enhanced MDCT and ^99mTc-Labeled RBC Scintigraphy

¹ Department of Radiology, Hartford Hospital, Hartford, CT.
² Department of Radiology, Duke University Medical Center, Durham, NC.
³ Present address: Department of Radiology, University of Connecticut–St. Francis Hospital and Medical Center, 1000 Asylum Ave., 3201E, Hartford, CT 06105.
⁴ Department of Surgery, University of Connecticut School of Medicine, Farmington, CT.

OBJECTIVE. The purpose of our study was to compare contrast-enhanced MDCT and ^99mTc-labeled RBC scanning for the evaluation of active lower gastrointestinal bleeding.

SUBJECTS AND METHODS. Over 17 months, 55 patients (32 men, 23 women; age range, 21–92 years) were evaluated prospectively with contrast-enhanced MDCT using 100 mL of iopromide 300 mg I/mL. Technetium-99m-labeled RBC scans were obtained on 41 of 55 patients and select patients underwent angiography for attempted embolization. Each imaging technique was reviewed in a blinded fashion for sensitivity for detection of active bleeding as well as the active lower gastrointestinal bleeding location.

RESULTS. Findings were positive on both examinations in eight patients and negative on both examinations in 20 patients. Findings were positive on contrast-enhanced MDCT and negative on ^99mTc-labeled RBC in two patients; findings were negative on contrast-enhanced MDCT and positive on ^99mTc-labeled RBC in 11 patients. Statistics showed significant disagreement, with simple agreement = 68.3%, = 0.341, and p = 0.014. Sixteen of 60 (26.7%) contrast-enhanced MDCT scans were positive prospectively, with all accurately localizing the site of bleeding and identification of the underlying lesion in eight of 16 (50%). Nineteen of 41 (46.3%) ^99mTc-labeled RBC scans were positive. Eighteen of 41 matched patients went on to angiography. In four of these 18 (22.2%) patients, the site of bleeding was confirmed by angiography, but in 14 of 18 (77.8%), the findings were negative.

CONCLUSION. Contrast-enhanced MDCT and ^99mTc-labeled RBC scanning show significant disagreement for evaluation of active lower gastrointestinal bleeding. Contrast-enhanced MDCT appears effective for detection and localization in cases of active lower gastrointestinal bleeding in which hemorrhage is active at the time of CT.

Keywords: colon • gastrointestinal • hemorrhage • MDCT • nuclear medicine

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?