Dig Dis Interv 2017; 01(S 04): S1-S20
DOI: 10.1055/s-0038-1641655
Poster Presentations
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Optimal Pre-procedural Imaging in Acute Lower Gastrointestinal Bleeding: Computed Tomographic Angiography vs. Nuclear Medicine Bleeding Scan

Ryan M. Cobb
1  Department of Interventional and Vascular Radiology, Temple University Health Systems, Philadelphia, Pennsylvania
,
Angelina Cords
2  Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
,
Wei Shaw
1  Department of Interventional and Vascular Radiology, Temple University Health Systems, Philadelphia, Pennsylvania
,
Emily Cuthbertson
1  Department of Interventional and Vascular Radiology, Temple University Health Systems, Philadelphia, Pennsylvania
,
Dimitry Niman
1  Department of Interventional and Vascular Radiology, Temple University Health Systems, Philadelphia, Pennsylvania
,
Joseph Panaro
1  Department of Interventional and Vascular Radiology, Temple University Health Systems, Philadelphia, Pennsylvania
,
David Pryluck
1  Department of Interventional and Vascular Radiology, Temple University Health Systems, Philadelphia, Pennsylvania
,
Gary S. Cohen
1  Department of Interventional and Vascular Radiology, Temple University Health Systems, Philadelphia, Pennsylvania
,
Mark Burshteyn
1  Department of Interventional and Vascular Radiology, Temple University Health Systems, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

Publication Date:
22 March 2018 (online)

 

Purpose Retrospective analysis was performed to assess the diagnostic utility of computed tomographic angiography (CTA) in active lower gastrointestinal bleeding (LGIB) as compared with nuclear medicine bleeding scan (NMBS) to determine the optimal diagnostic imaging modality prior to visceral arteriography (VA).

Materials and Methods From January 2013 through February 2016, 56 patients underwent a total of 64 VA at our institution. Results of CTA and NMBS immediately preceding VA and time interval from the completion of the diagnostic imaging study to the initiation of VA were analyzed. CTA and VA were considered positive if active contrast extravasation or pseudoaneurysm was identified in the gastrointestinal tract distal to the ligament of Treitz. NMBS was considered positive if increased radiotracer pooling was localized in the gastrointestinal tract distal to the ligament of Treitz.

Results Twenty-eight NMBS and 30 CTAs were performed prior to VA. Twenty-seven (96%) out of 28 NMBS were positive. Of the 27 positive NMBS, 4 (15%) patients had a subsequent positive VA. Twenty-eight (93%) out of 30 CTAs were positive. Of the 28 positive CTA, 15 (54%) had a subsequent positive VA. Mean and median times between positive diagnostic study and VA are as follows: NMBS mean 517.59 minutes, median 318 minutes, and CTA mean 188.18 minutes and median 136 minutes with a p-value <0.0006.

Conclusion CTA is a better predictor of subsequent VA findings in evaluation of LGIB as compared with nuclear scintigraphy. Preferable technical and logistical aspects of CTA lead to reduction in time from positive CTA to potentially therapeutic VA.

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Fig. 1