Lee Sun Mi, Kim Tae Oh, Park Hyoung Yoel, Kim Kyung Yeob, Kim Gwang Ha, Kang Dae Hwan, Song Geun Am, Kim Suk
Department of Internal Medicine, Pusan National University School of Medicine, Seo-gu, Busan, Korea.
Korean J Gastroenterol. 2008 May;51(5):298-304.
BACKGROUND/AIMS: Recent studies have shown good performance for the detection of sources of gastrointestinal bleeding using multi-detector row computed tomography (MDCT). However, there are limited reports about the role of MDCT for localization of acute lower gastrointestinal (GI) bleeding. The purpose of this study was to evaluate the role of MDCT for detection and localization of acute lower gastrointestinal bleeding.
A total of 49 patients underwent MDCT examination for the evaluation of acute lower GI bleeding were investigated prospectively. Sensitivity, specificity, positive and negative predictive values of MDCT for the detection of acute lower GI bleeding were assessed. Colonoscopy, angiography, RBC scan or postoperative results were adopted as the reference standard.
Sensitivity, specificity, positive and negative predictive values of MDCT for the detection of acute lower GI bleeding were 72.7%, 80%, 93.9% and 25%, respectively. Eighteen patients experienced massive bleeding and 5 of them could not undergo the colonoscopic examination due to massive bleeding. MDCT detected the bleeding focuses in all of 5 patients.
MDCT is useful for the localization of acute lower GI bleeding. The procedure is brief, less invasive, and relatively accurate diagnostic method. Moreover, positive finding will allow directed therapeutic procedure such as angiography.
背景/目的：近期研究表明，使用多排螺旋计算机断层扫描（MDCT）检测胃肠道出血源具有良好的效果。然而，关于MDCT在急性下消化道（GI）出血定位中的作用的报道有限。本研究的目的是评估MDCT在检测和定位急性下消化道出血中的作用。
前瞻性调查了49例因评估急性下消化道出血而接受MDCT检查的患者。评估了MDCT检测急性下消化道出血的敏感性、特异性、阳性和阴性预测值。采用结肠镜检查、血管造影、红细胞扫描或术后结果作为参考标准。
MDCT检测急性下消化道出血的敏感性、特异性、阳性和阴性预测值分别为72.7%、80%、93.9%和25%。18例患者发生大出血，其中5例因大出血无法进行结肠镜检查。MDCT在所有5例患者中均检测到出血部位。
MDCT对急性下消化道出血的定位有用。该检查操作简便、侵入性小，是一种相对准确的诊断方法。此外，阳性结果可进行如血管造影等有针对性的治疗。
