Evaluation of dual-phase multi-detector-row CT for detection of intestinal bleeding using an experimental bowel model

Martin Dobritz, Heinz Peter Engels, Armin Schneider, Hinrich Wieder, Hubertus Feussner, Ernst J. Rummeny, Jens C. Stollfuss

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

To evaluate dual-phase multi-detector-row computed tomography (MDCT) in the detection of intestinal bleeding using an experimental bowel model and varying bleeding velocities. The model consisted of a high pressure injector tube with a single perforation (1 mm) placed in 10-m-long small bowel of a pig. The bowel was filled with water/contrast solution of 30-4 HU 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 s) was simulated. Nineteen complete datasets in arterial and portal-venous phase using increasing bleeding velocities, and seven negative controls were measured using a 64 MDCT (3-mm slice thickness, 1.5-mm reconstruction increment). Three 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. The sensitivity to detect bleeding was 0.44 for a bleeding velocity of 0.10-0.50 ml/min and 0.97 for 0.55-1.00 ml/min. The specificity was 1.00. The area under the curve was calculated to be 0.73, 0.88 and 0.89 for reader 1, 2 and 3, respectively. Dual-phase MDCT provides high sensitivity and specificity in the detection of intestinal bleeding with bleeding velocities of 0.5-1.0 ml/min. Therefore, MDCT should be considered as a primary diagnostic technique in the management of patients with suspected intestinal bleeding.

Original languageEnglish
Pages (from-to)875-881
Number of pages7
JournalEuropean Radiology
Volume19
Issue number4
DOIs
StatePublished - 2009

Keywords

  • Abdominal imaging
  • Computed tomography
  • Intestinal bleeding

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