Martin Dobritz MD, Presenter: Nothing to Disclose

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

Armin Schneider Dipl Eng, Abstract Co-Author: Nothing to Disclose

Heinz-Peter Engels MD, Abstract Co-Author: Nothing to Disclose

Hinrich Wieder, Abstract Co-Author: Nothing to Disclose

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

To evaluate dual-phase Multislice-Computed-Tomography (MSCT) in the detection of intestinal bleeding using an experimental bowel-bleeding model.

The model consisted of a high pressure injector tube with a single perforation (1mm) placed in 10m small bowel of a pig at different locations. The bowel was filled with water/contrast solution of 30-40 HE and was incorporated in a phantom model containing vegetable oil to simulate mesenteric fat. Intestinal bleeding in different locations and bleeding velocities varying from zero to 1 ml/min (0.05 ml/min increments, constant bleeding duration of 20 sec) was simulated. 19 complete datasets in arterial and portal-venous phase using increasing bleeding velocities and 7 negative controls were measured using a 64-row MSCT (3mm slice thickness, 1.5 mm reconstruction increment). Two radiologists blinded to the experimental settings evaluated the datasets in a random order. The likelihood for intestinal bleeding was assessed using a 5 point scale with subsequent ROC analysis.

A bleeding velocity of 0.1-0.5 and 0.5-1.0 ml/min was detected with a mean sensitivity of 0.50 and 0.95, respectively. The specificity was 1.00. The area under curve was measured to be 0.88 and 0.89 for reader 1 and 2, respectively.

Dual phase MSCT provided high sensitivity and specificity in the detection of intestinal bleeding with bleeding velocities of 0.5-1.0 ml/min. Therefore, MSCT should be considered as a primary diagnostic technique in the management of patients with suspected intestinal bleeding.

MSCT seems to be better in the detection of intestinal bleeding compared to angiography or scintigraphy.

Dobritz, M, Stollfuss, J, Schneider, A, Engels, H, Wieder, H, Rummeny, E, Dual-phase MSCT in the Detection of Intestinal Bleeding.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5008881.html