The diagnostic value of double filling method in CT angiography in the diagnosis of#br#
obscure gastrointestinal bleeding in the large and small intestine
Department of Imaging, the People’s Hosptial of Yangzhong, Yangzhong Jiangsu 212200, China
Abstract：Objective: To investigate the diagnostic value of double filling method in CT angiography in the diagnosis of obscure gastrointestinal bleeding(OGIB) in the large and small intestine. Methods: Retrospective analysis of 30 patients from clinical data with OGIB, all cases underwent the intestinal double filling method CT. Results: There were 5 cases of malignant tumor, 4 cases of small intestinal stromal tumor, and 1 case of lipoma, furthermore coarse vascular malformation was found in 4 cases, telangiectasia in 2 cases, inflammatory bowel disease in 5 cases, intestinal polyps in 3 cases, superior mesenteric artery thrombosis formation in 2 cases, mesenteric venous thrombosis formation in 1 case, diverticulum in 2 cases, heterotopic pancreas in 1 case. Ten cases were confirmed by operation and pathology, 6 cases confirmed by capsule endoscopy, 4 cases of vascular lesions confirmed by DSA, and the other 10 cases of intestinal CT were consistent with clinical diagnosis. The diagnostic accuracy rate of CT was 73.3% in this group by using the small intestine double filling method in this group. Omission lesions included 2 cases of vascular malformation, 2 cases of capillary dilatation, 2 cases of small polypoid lesions, 2 cases of intestinal mucosal hyperaemia erosion. The reason was that the expansion of the blood vessels is small, small polyps and intestinal mucosa was difficult to distinguish, the superficial mucosal lesions was not sensitive. Conclusion: The large and small intestine double filling bowel CT angiography on the positioning of OGIB, qualitative diagnosis and guiding clinical formulation treatment has important clinical value, but it is likely to be misdiagnosed by shallow table mucosa lesions and vascular lesions.
杜国忠，朱北川. 大小肠双充盈法肠道CT造影对不明原因消化道出血的诊断价值[J]. 中国临床医学影像杂志, 2016, 27(2): 114-117.
DU Guo-zhong, ZHU Bei-chuan. The diagnostic value of double filling method in CT angiography in the diagnosis of#br#
obscure gastrointestinal bleeding in the large and small intestine. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(2): 114-117.
[1]Filippone A, Cianci Ｒ, Milano A, et al． Obscure and occult gastrointestinal bleeding: comparison of different imaging modalities[J]． Abdom Imaging, 2012, 37(1): 41-52.
[2]Raju GS, Gerson L, Das A, et al． American Gastroenterological Association(AGA) institute technical review on obscure gastrointestinal bleeding[J]． Gastroenterology, 2007, 133(5): 1694-1696.
[3]Huprich JE, Fletcher JG, Alexander JA, et al． Obscure gastrointestinal bleeding: evaluation with 64-section multiphase CT enterography-initial experience[J]． Radiology, 2008, 246(2): 562-571.
[4]Sun H, Jin Z, Li X, et al． Detection and localization of active gastrointestinal bleeding with multidetector row computed tomography angiography: a 5-year prospective study in one medical center[J]． J Clin Gastroenterol, 2012, 46(1): 31-41.
[5]邓灵波，李晓光，明韦迪，等. 多层螺旋CT对不明原因消化道出血的诊断价值-Meta分析[J]. 临床放射学杂志，2014，33（10）：1540-1543.
[6]Boudiaf M, Jaff A, Soyer P, et al. Small-bowel diseases: prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients[J]. Radiology, 2004, 233(2): 338-344.
[7]刘克昌，项微微，张胜兰，等. 大小肠双充盈法多层螺旋CT肠道成像对炎症性肠病的诊断价值[J]. 中国医学影像学杂志，2015，23（1）：14-18.
[8]Shim KN, Moon JS, Chang DK, et al． Guideline for capsule endoscopy: obscure gastrointestinal bleeding[J]． Clin Endosc, 2013, 46(1): 45-53.
[9]Zhang BL, Jiang LL, Chen CX, et al． Diagnosis of obscure gastrointestinal hemorrhage with capsule endoscopy in combination with multiple-detector computed tomography[J]. J Gastroenterol Hepatol, 2010, 25(1): 75-79.
[10]中华消化杂志编辑委员会. 不明原因消化道出血诊治推荐流程[J]. 中华消化杂志，2012，32（6）：361-363.
