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高级CT血管造影术在检测罕见动静脉畸形中的应用:应对隐匿性胃肠道出血的诊断挑战

Advanced CT angiography in detecting rare arterio-venous malformations: Addressing diagnostic challenges in obscure gastrointestinal bleeding.

作者信息

Kanna Swathi Tapaswi, Rajavel Kaushik, Nayyer Shoa, Gnanasekaran Pritika, Ramesh Priyadarshini, Panda Anshuman Kumar

机构信息

Department of Medicine, Royal Albert Edward Infirmary, Wigan Wrightington and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, United Kingdom.

Department of Orthopaedics, Madras Medical College, Chennai, Tamil Nadu, India.

出版信息

Bioinformation. 2024 Dec 31;20(12):1917-1921. doi: 10.6026/9732063002001917. eCollection 2024.

Abstract

Gastrointestinal bleeding is a common clinical issue, but obscure gastrointestinal bleeding (OGIB) presents significant diagnostic challenges, especially when caused by arteriovenous malformations (AVMs). This study explored the role of advanced CT angiography (CTA) in diagnosing and managing AVM-related OGIB in 100 patients. CTA identified AVMs in 12% of cases where standard endoscopy failed (p < 0.001) and guided successful surgical control of bleeding in 95% of these cases. The sensitivity of CTA (92%) was significantly higher compared to other imaging modalities (68%; p = 0.002), particularly for small or inaccessible lesions. These findings underscore CTA's crucial role in improving diagnostic accuracy and enabling targeted therapeutic interventions for challenging cases of OGIB.

摘要

胃肠道出血是一个常见的临床问题,但不明原因的胃肠道出血(OGIB)带来了重大的诊断挑战,尤其是由动静脉畸形(AVM)引起时。本研究探讨了先进的CT血管造影(CTA)在100例与AVM相关的OGIB诊断和管理中的作用。在标准内镜检查失败的病例中,CTA在12%的病例中识别出AVM(p<0.001),并在其中95%的病例中指导成功地控制了出血。与其他成像方式(68%;p=0.002)相比,CTA的敏感性(92%)显著更高,特别是对于小的或难以到达的病变。这些发现强调了CTA在提高诊断准确性和为具有挑战性的OGIB病例进行靶向治疗干预方面的关键作用。

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