Martin Dobritz MD, Presenter: Nothing to Disclose

Wolfgang Weiss, Abstract Co-Author: Nothing to Disclose

Jens C Stollfuss MD, Abstract Co-Author: Nothing to Disclose

Ernst Josef Rummeny MD, Abstract Co-Author: Nothing to Disclose

To evaluate the diagnostic performance of Multislice-Computed-Tomography (MSCT) including CT-based angiography in patients with suspected gastrointestinal bleeding or mesenteric ischemia.

49 consecutive patients presenting with symptoms suggestive for intestinal bleeding (n=17) or mesenteric ischemia (n=32) were investigated. MSCT (16 slice MSCT in 47 patients, 64 slice MSCT in 2 patients) was acquired including an arterial and portalvenous phase (120ml iodinated contrast media, 4-5 ml/sec bolus flow, 16x0.75 mm collimation, 64x0.6mm collimation). In conjunction to standard image reading, interactively image interpretation was done with respect to vessel structures using a 3D workstation. Standard of reference for the final diagnosis was surgical intervention or clinical follow up.

Five of 6 patients with confirmed mesenteric ischemia were correctly diagnosed by MSCT (Sensitivity 83%). MSCT was able to demonstrate other potential causes for abdominal pain in 18 of the remaining 26 patients in this group with suspected ischemia including mesentric vein thrombosis, inguinal herniation, large bowel perforation, pneumonia, tumors. 11/11patients with confirmed gastrointestinal bleeding were correctly indentified by MSCT (Sensitivity 100%). Other findings in this group that were likley to explain for the symptoms of the patients were found in 5 of the remaining 6 cases (GIST 3, NHL 1, Hematoma 1).

MSCT in conjunction with CT-angiography is highly reliable in the diagnosis of patients presenting with suspected bleeding or mesenteric ischemia. MSCT also shows important other causes of abdominal pain in patients without evidence of bleeding or ischemia. Thus, it should be used as the primary diagnostic technique in the management of these patients.

Dobritz, M, Weiss, W, Stollfuss, J, Rummeny, E, MSCT with Combined CT-Angiography for Diagnosis of Suspected Mesenteric Ischemia or Intestinal Bleeding.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4410990.html