Document Detail

The value of multidetector-row computed tomography for localization of obscure acute gastrointestinal bleeding.
MedLine Citation:
PMID:  20621429     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: There are no simple guidelines on when to perform multidetector-row computed tomography (MDCT) for diagnosis of obscure acute gastrointestinal bleeding (AGIB). We used a risk scoring system to evaluate the diagnostic power of MDCT for patients with obscure AGIB.
MATERIALS AND METHODS: Ninety-two patients with obscure AGIB who were referred for an MDCT scan after unsuccessful endoscopic treatment at presentation were studied. We recorded clinical data and calculated Blatchford score for each patient. Patients who required transfusion more than 500mL of blood to maintain the vital signs were classified as high-risk patients. Two radiologists independently reviewed and categorized MDCT signs of obscure AGIB. Discordant findings were resolved by consensus. One-way ANOVA was used to compare clinical data between two groups; kappa statistics were used to estimate agreement on MDCT findings between radiologists.
RESULTS: Of the 92 patients, 62 (67.4%) were classified as high-risk patients. Blatchford scores of high-risk patients were significantly greater than those of low-risk patients. Sensitivity for MDCT diagnosing obscure AGIB was 81% in high-risk patients, as compared with 50% in the low-risk. When used in conjunction with selection of the cut-off value of 13 in Blatchford scoring system, the sensitivity and specificity of MDCT were 70.9% and 73.7%, respectively. Contrast extravasation was the most specific sign of AGIB (k=.87), recognition of which would have improved diagnostic accuracy.
CONCLUSIONS: With the aid of Blatchford scoring system for evaluating the disease severity, MDCT can localize the bleeders of obscure AGIB more efficiently.
Wei-Chou Chang; Shih-Hung Tsai; Wei-Kuo Chang; Chang-Hsien Liu; Ho-Jui Tung; Chung-Bao Hsieh; Guo-Shu Huang; Hsian-He Hsu; Chih-Yung Yu
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Publication Detail:
Type:  Journal Article     Date:  2010-07-10
Journal Detail:
Title:  European journal of radiology     Volume:  80     ISSN:  1872-7727     ISO Abbreviation:  Eur J Radiol     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  229-35     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan, ROC.
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