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

Autor:	Cacioppa LM; Division of Interventional Radiology, Department of Radiological Sciences, University Politecnica Delle Marche, Ancona 60126, Italy.; Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, Ancona 60126, Italy.; Laura Maria Cacioppa and Chiara Floridi., Floridi C; Division of Interventional Radiology, Department of Radiological Sciences, University Politecnica Delle Marche, Ancona 60126, Italy.; Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, Ancona 60126, Italy.; Division of Radiology, Department of Radiological Sciences, University Hospital 'Azienda Ospedaliero Universitaria Delle Marche', Ancona 60126, Italy.; Laura Maria Cacioppa and Chiara Floridi., Bruno A; Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, Ancona 60126, Italy., Rossini N; Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, Ancona 60126, Italy., Valeri T; Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, Ancona 60126, Italy., Borgheresi A; Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, Ancona 60126, Italy., Inchingolo R; Interventional Radiology Unit, 'F Miulli' Regional General Hospital, Acquaviva delle Fonti 70021, Italy. riccardoin@hotmail.it., Cortese F; Interventional Radiology Unit, 'F Miulli' Regional General Hospital, Acquaviva delle Fonti 70021, Italy., Novelli G; Department of Radiology, IRCCS INRCA, Ancona 60126, Italy., Felicioli A; Division of Interventional Radiology, Department of Radiological Sciences, University Politecnica Delle Marche, Ancona 60126, Italy., Torresi M; Division of Interventional Radiology, Department of Radiological Sciences, University Politecnica Delle Marche, Ancona 60126, Italy., Boscarato P; Division of Interventional Radiology, Department of Radiological Sciences, University Politecnica Delle Marche, Ancona 60126, Italy., Ottaviani L; Division of Radiology, Department of Radiological Sciences, University Hospital 'Azienda Ospedaliero Universitaria Delle Marche', Ancona 60126, Italy., Giovagnoni A; Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, Ancona 60126, Italy.; Division of Radiology, Department of Radiological Sciences, University Hospital 'Azienda Ospedaliero Universitaria Delle Marche', Ancona 60126, Italy.
Jazyk:	angličtina
Zdroj:	World journal of radiology [World J Radiol] 2024 May 28; Vol. 16 (5), pp. 115-127.
DOI:	10.4329/wjr.v16.i5.115
Abstrakt:	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. Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article. (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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