Chinmay Bhimaji Kulkarni MBBS, MD, Presenter: Nothing to Disclose

Srikanth Moorthy MD, Abstract Co-Author: Nothing to Disclose

Sreekumar K P MBBS, MD, Abstract Co-Author: Nothing to Disclose

Rajesh Ramaih Kannan MD, Abstract Co-Author: Nothing to Disclose

To prospectively determine the sensitivity of 64-slice MDCT angiography in detecting and diagnosing the cause of obscure gastrointestinal bleed (OGIB). 

The study included 132 patients (male 93, female 39) in the age range of 3 –87 years (average age 55.13 years) who were referred to radiology department as part of workup for clinically evident gastrointestinal bleed or as part of workup for anemia (with and without positive fecal occult blood test) between 2007-2013. MDCT angiography was performed only after conventional upper endoscopy and colonoscopy were negative. Following a non-contrast scan, all patients underwent triple-phase contrast CT scan using a 64-slice CT scan system. The diagnostic performance of MDCT angiography was compared to the results of capsule endoscopy, 99m-technetium-labeled red blood cell scintigraphy (99mTc-RBC scintigraphy), digital subtraction angiography, and surgery whenever available.

CT scan showed positive findings in 80 of 132 patients. The sensitivity, specificity, positive predictive value, and negative predictive values of MDCT angiography for detection of bleed were 74.7%, 66.7%, 81.2%, and 57.7%, respectively. Capsule endoscopy was performed in 36 patients and was positive in 21 patients (sensitivity 78.2%). 99mTc-RBC scintigraphy was performed in 16 patients and was positive in 10 patients (sensitivity 71.4%). Digital subtraction angiography was performed in 34 patients and was positive in 28 patients (sensitivity 90.3%). 

MDCT angiography is a sensitive and noninvasive tool that allows rapid detection and localization of OGIB. It can be used as the first-line investigation in patients with negative endoscopy and colonoscopy studies. MDCT and capsule endoscopy have complementary roles in the evaluation of OGIB.

MDCT angiography  is a sensitive and noninvasive tool that allows rapid detection and localization of obscure gastrointestinal bleed and can be used as the first-line investigation in patients with negative endoscopic  studies. 

Kulkarni, C, Moorthy, S, K P, S, Kannan, R, In the Work-up of Patients with Obscure Gastrointestinal Bleed, Does 64-slice MDCT Angiography Have a Role?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003121.html