Computed Tomography in Gastrointestinal Bleeding
Palabras clave
Abstracto
Descripción
A number of 30 Patients with Acute Gastrointestinal bleeding will be included in the study.
To maximise detection capabilities, it is crucial that Computed tomography angiography should begin as soon as possible while the patient is actively bleeding. Patients with active Gastrointestinal bleeding are assigned to intensive care units, and patients in shock are promptly resuscitated. Intensive care unit physicians provide appropriate monitoring for hemodynamically unstable patients undergoing Multidetector computed tomography angiography. Multidetector computed tomography angiography should be performed without prior oral administration of water or contrast material. Active contrast material extravasation within the bowel lumen is obscured by oral contrast material, leading to false-negative results.
Data acquisition: Investigators will perform Multidetector computed tomography angiography with 16- Multislice computed tomography scanner, medical system bright speed. The protocol will include non-enhanced scanning then perform a triphasic angiography that includes arterial, portal and venous phases to detect acute Gastrointestinal bleeding.
Images will be acquired with the following parameters slice thickness 5mm for the unenhanced phase and 1.25mm for the arterial phase and Porto-venous phases, pitch 1.375, 300 Miliambiar, 120kilovolt and rotation time 0.7 seconds.
Images acquired are reconstructed for coronal, sagittal, Volume Rendering and Maximum Intensity Projection images. A similar protocol may be used with a 64-Multislice computed tomography scanner.
A dose of 1-2 ml/kg body weight of concentration 370mg/ml non-ionized contrast media will be administered at a rate of 4ml/sec, with an upper limit of 150ml. Venous access is an antecubital vein with a 14 or at least 18G cannula. The scan delay time for the arterial phase images is obtained by using bolus tracking with a circular region of interest positioned in the abdominal aorta and a predefined 90-housenfield unit bolus-trigger threshold to the start of automatic scanning. The coverage from just above the diaphragm to the Ischial tuberosities including the rectum in all cases.
Study interpretation post processing will be performed with a 4.6 version workstation. All studies are reviewed in the axial plane and with multiplanar reformation images. Real-time maximum-intensity projection images facilitate rapid study interpretation for optimal case management.
The radiologist will try to get the following information:
- presence or absence of bleeding.
- localise the site of bleeding.
- detect the cause of bleeding: tumour, Arteriovenous malformations….. The confirmation of the triphasic Multislice computed tomography results will be done by angiographic intervention and embolization of bleeding vessel
fechas
Verificado por última vez: | 07/31/2017 |
Primero enviado: | 07/09/2017 |
Inscripción estimada enviada: | 08/03/2017 |
Publicado por primera vez: | 08/07/2017 |
Última actualización enviada: | 08/03/2017 |
Última actualización publicada: | 08/07/2017 |
Fecha de inicio real del estudio: | 08/31/2017 |
Fecha estimada de finalización primaria: | 07/31/2018 |
Fecha estimada de finalización del estudio: | 11/30/2018 |
Condición o enfermedad
Intervención / tratamiento
Diagnostic Test: mutlidetector computed tomography
Fase
Criterio de elegibilidad
Sexos elegibles para estudiar | All |
Método de muestreo | Probability Sample |
Acepta voluntarios saludables | si |
Criterios | Inclusion Criteria: - patients with unexplained non variceal gastrointestinal bleeding Exclusion Criteria: - patients with impaired renal functions or terminal liver failure. pregnancy. patients known to be sensitive to contrast media. cases diagnosed endoscopically as variceal bleeding. |
Salir
Medidas de resultado primarias
1. Role of triphasic computed tomography imaging in detection of acute non variceal gastrointestinal tract bleeding [one year]