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Dual-Energy CT Evaluation of Gastrointestinal Bleeding.

Publication ,  Journal Article
Dane, B; Gupta, A; Wells, ML; Anderson, MA; Fidler, JL; Naringrekar, HV; Allen, BC; Brook, OR; Bruining, DH; Gee, MS; Grand, DJ; Kastenberg, D ...
Published in: Radiographics
June 2023

Gastrointestinal (GI) bleeding is a potentially life-threatening condition accounting for more than 300 000 annual hospitalizations. Multidetector abdominopelvic CT angiography is commonly used in the evaluation of patients with GI bleeding. Given that many patients with severe overt GI bleeding are unlikely to tolerate bowel preparation, and inpatient colonoscopy is frequently limited by suboptimal preparation obscuring mucosal visibility, CT angiography is recommended as a first-line diagnostic test in patients with severe hematochezia to localize a source of bleeding. Assessment of these patients with conventional single-energy CT systems typically requires the performance of a noncontrast series followed by imaging during multiple postcontrast phases. Dual-energy CT (DECT) offers several potential advantages for performing these examinations. DECT may eliminate the need for a noncontrast acquisition by allowing the creation of virtual noncontrast (VNC) images from contrast-enhanced data, affording significant radiation dose reduction while maintaining diagnostic accuracy. VNC images can help radiologists to differentiate active bleeding, hyperattenuating enteric contents, hematomas, and enhancing masses. Additional postprocessing techniques such as low-kiloelectron voltage virtual monoenergetic images, iodine maps, and iodine overlay images can increase the conspicuity of contrast material extravasation and improve the visibility of subtle causes of GI bleeding, thereby increasing diagnostic confidence and assisting with problem solving. GI bleeding can also be diagnosed with routine single-phase DECT scans by constructing VNC images and iodine maps. Radiologists should also be aware of the potential pitfalls and limitations of DECT. ©RSNA, 2023 Quiz questions for this article are available through the Online Learning Center.

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Published In

Radiographics

DOI

EISSN

1527-1323

Publication Date

June 2023

Volume

43

Issue

6

Start / End Page

e220192

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Radiography, Dual-Energy Scanned Projection
  • Nuclear Medicine & Medical Imaging
  • Iodine
  • Intestine, Small
  • Humans
  • Gastrointestinal Hemorrhage
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Dane, B., Gupta, A., Wells, M. L., Anderson, M. A., Fidler, J. L., Naringrekar, H. V., … Guglielmo, F. F. (2023). Dual-Energy CT Evaluation of Gastrointestinal Bleeding. Radiographics, 43(6), e220192. https://doi.org/10.1148/rg.220192
Dane, Bari, Avneesh Gupta, Michael L. Wells, Mark A. Anderson, Jeff L. Fidler, Haresh V. Naringrekar, Brian C. Allen, et al. “Dual-Energy CT Evaluation of Gastrointestinal Bleeding.Radiographics 43, no. 6 (June 2023): e220192. https://doi.org/10.1148/rg.220192.
Dane B, Gupta A, Wells ML, Anderson MA, Fidler JL, Naringrekar HV, et al. Dual-Energy CT Evaluation of Gastrointestinal Bleeding. Radiographics. 2023 Jun;43(6):e220192.
Dane, Bari, et al. “Dual-Energy CT Evaluation of Gastrointestinal Bleeding.Radiographics, vol. 43, no. 6, June 2023, p. e220192. Pubmed, doi:10.1148/rg.220192.
Dane B, Gupta A, Wells ML, Anderson MA, Fidler JL, Naringrekar HV, Allen BC, Brook OR, Bruining DH, Gee MS, Grand DJ, Kastenberg D, Khandelwal A, Sengupta N, Soto JA, Guglielmo FF. Dual-Energy CT Evaluation of Gastrointestinal Bleeding. Radiographics. 2023 Jun;43(6):e220192.

Published In

Radiographics

DOI

EISSN

1527-1323

Publication Date

June 2023

Volume

43

Issue

6

Start / End Page

e220192

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Radiography, Dual-Energy Scanned Projection
  • Nuclear Medicine & Medical Imaging
  • Iodine
  • Intestine, Small
  • Humans
  • Gastrointestinal Hemorrhage
  • 3202 Clinical sciences
  • 1103 Clinical Sciences