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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2012; 22(01): 47-53
DOI: 10.4103/0971-3026.95404
GI Radiology

In the workup of patients with obscure gastrointestinal bleed, does 64-slice MDCT have a role?

Chinmay Kulkarni
Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Elamakkara, Cochin, Kerala, India
,
Srikanth Moorthy
Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Elamakkara, Cochin, Kerala, India
,
K Sreekumar
Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Elamakkara, Cochin, Kerala, India
,
R Rajeshkannan
Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Elamakkara, Cochin, Kerala, India
,
P Nazar
Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Elamakkara, Cochin, Kerala, India
,
C Sandya
Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Elamakkara, Cochin, Kerala, India
,
S Sivasubramanian
Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Elamakkara, Cochin, Kerala, India
,
P Ramchandran
Department of Radiology, Amrita Institute of Medical Sciences and Research Center, Elamakkara, Cochin, Kerala, India
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Abstract

Purpose: The purpose was to prospectively determine the sensitivity of 64-slice MDCT in detecting and diagnosing the cause of obscure gastrointestinal bleed (OGIB). Materials and Methods: Our study included 50 patients (male 30, female 20) in the age range of 3-82 years (average age: 58.52 years) who were referred to our radiology department as part of their workup for clinically evident gastrointestinal (GI) bleed or as part of workup for anemia (with and without positive fecal occult blood test). All patients underwent conventional upper endoscopy and colonoscopy before undergoing CT scan. Following a noncontrast scan, all patients underwent triple-phase contrast CT scan using a 64-slice CT scan system. The diagnostic performance of 64-slice MDCT 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. Results: CT scan showed positive findings in 32 of 50 patients. The sensitivity, specificity, positive predictive value, and negative predictive values of MDCT for detection of bleed were 72.2%, 42.8%, 81.2%, and 44.4%, respectively. Capsule endoscopy was done in 15 patients and was positive in 10 patients; it had a sensitivity of 71.4%. Eleven patients had undergone 99mTc-RBC scintigraphy prior to CT scan, and the result was positive in seven patients (sensitivity 70%). Digital subtraction angiography was performed in only eight patients and among them all except one patient showed findings consistent with the lesions detected on MDCT. Conclusion: MDCT 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.

Keywords

Arteriography digital subtraction - capsule endoscopy - diagnosis - gastrointestinal hemorrhage - spiral cone-beam computed tomography


Publication History

Article published online:
30 July 2021

© 2012. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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