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- “Varices cause approximately 30% of all episodes of upper gastrointestinal tract bleeding. CT angiography should be considered when endoscopy does not reveal a bleeding source and when there is a suspicion of arterial bleeding or a source in the lower gastrointestinal tract.”
Multidetector CT Angiography for Acute Gastrointestinal Bleeding: Technique and Findings José M. Artigas et al. RadioGraphics 2013; 33:1453–1470 - “Upper gastrointestinal tract bleeding may also occur in patients who are hospitalized for other causes; stress ulcers can appear within 24 hours of admission in a patient who has suffered severe trauma or burns.”
Multidetector CT Angiography for Acute Gastrointestinal Bleeding: Technique and Findings José M. Artigas et al. RadioGraphics 2013; 33:1453–1470 - “CT angiography is usually performed when endoscopy is not feasible or is nondiagnostic, but in most cases, CT angiography can be completed while preparing for endoscopy. Even when active hemorrhage has ceased, CT findings may assist in risk stratification and may be helpful in selecting the best option for definitive treatment, as well as its optimal timing.”
Multidetector CT Angiography for Acute Gastrointestinal Bleeding: Technique and Findings José M. Artigas et al. RadioGraphics 2013; 33:1453–1470 - “Acute GI bleeding can have arterial and venous sources. Venous bleeding within the upper GI tract is typically due to gastric or esophageal varices in the setting of portal hypertension. However, nearly 30% of patients with portal hypertension who have upper GI bleeding will have an arterial source of bleeding .The most common causes of upper GI bleeding are erosion or peptic ulcer disease. Multidetector CT angiography can also help diagnose rare bleeding related to interventional endoscopic procedures such as endoscopic sphincterotomy of the ampulla.”
Multidetector CT Angiography in Acute Gastrointestinal Bleeding: Why, When, and How Geffroy Y et al. RadioGraphics 2011; 31:35–E47 - “Acute gastrointestinal (GI) bleeding is a common major medical emergency with an annual incidence of 40–150 episodes per 100,000 persons for upper GI bleeding and 20–27 episodes per 100,000 persons for lower GI bleeding. In as many as 75% of cases, bleeding ceases spontaneously; however, bleeding can recur in 25% of cases, causing substantial morbidity and mortality.”
Multidetector CT Angiography in Acute Gastrointestinal Bleeding: Why, When, and How Geffroy Y et al. RadioGraphics 2011; 31:35–E47 - “Upper GI bleeding occurs proximal to the liga- ment of Treitz (which connects the fourth portion of the duodenum to the diaphragm) and arises from the esophagus, stomach, or duodenum. Lower GI bleeding involves the small bowel, colon, or rectum.”
Multidetector CT Angiography in Acute Gastrointestinal Bleeding: Why, When, and How Geffroy Y et al. RadioGraphics 2011; 31:35–E47 - “Inadequate gastric distention limits diagnostic evaluation of the stomach and poses a potential pitfall, as it may create a false appearance of thickening or, conversely, may obscure true disease. When evaluating abnormal gastric wall thickening in a nondistended stomach, supplementary findings can be helpful in identifying disease.”
CT of Gastric Emergencies Guniganti PG et al. RadioGraphics 2015; 35:1909–1921 - “The CT features of gastritis can overlap with malignancy. Certain features, such as the presence of mural stratification, favor inflammation, but when gastritis is focal or nodular in appearance, endoscopy and biopsy are often needed to exclude malignancy.”
CT of Gastric Emergencies Guniganti PG et al. RadioGraphics 2015; 35:1909–1921
"In our study, MDCT had results comparable with those of conventional gastroscopy in differentiation of malignant and benign gastric ulcers."
MDCT for Differentiation of Category T1 and T2 Malignant Lesions from Benign Gastric Ulcers
Chen CY et al.
AJR 2008; 190:1505-1511"In our study, MDCT had results comparable with those of conventional gastroscopy in differentiation of malignant and benign gastric ulcers. The sensitivity was 80.8-90.9% and the specificity was 73.1-77.8% on virtual gastroscopic images and the sensitivity 73.1%-80.8% and the specificity on MPR images."
MDCT for Differentiation of Category T1 and T2 Malignant Lesions from Benign Gastric Ulcers
Chen CY et al.
AJR 2008; 190:1505-1511"MDCT combined with virtual gastroscopy and multiplanar reconstruction enhances the morphologic details of gastric ulcers and is a useful way to differentiate malignant (T1 and T2) and benign gastric ulcers."
MDCT for Differentiation of Category T1 and T2 Malignant Lesions from Benign Gastric Ulcers
Chen CY et al.
AJR 2008; 190:1505-1511"In discriminating between T3 and T4 tumors, even if the fat plane intervening between the primary tumor and adjacent organ is effaced, invasion is not likely to be present if a distinct and smooth interface is maintained between them, whereas an indistinct or irregular interface probably suggests invasion."
Staging of T3 and T4 Gastric Carcinoma with Multiplanar CT: Added Value of Multiplanar Reformations for Prediction of Adjacent Organ Invasion
Kim YH et al.
Radiology 2009; 250:767-775"A combination of transverse CT and multiplanar reconstruction (MPR) is more accurate than transverse CT images alone in aiding prediction of tumor invasion of adjacent organs, particularly the transverse colon or mesocolon and pancreas, and , therefore in helping to identify patients with T4 gastric cancer."
Staging of T3 and T4 Gastric Carcinoma with Multiplanar CT: Added Value of Multiplanar Reformations for Prediction of Adjacent Organ Invasion
Kim YH et al.
Radiology 2009; 250:767-775- "MPR images are useful in identifying candidates for extended surgery and in planning appropriate surgical procedures."
Staging of T3 and T4 Gastric Carcinoma with Multiplanar CT: Added Value of Multiplanar Reformations for Prediction of Adjacent Organ Invasion
Kim YH et al.
Radiology 2009; 250:767-775 "Adding MPR images to transverse CT images improves the capability for distinguishing T3 from T4 gastric cancer and prediction of adjacent organ invasion."
Staging of T3 and T4 Gastric Carcinoma with Multiplanar CT: Added Value of Multiplanar Reformations for Prediction of Adjacent Organ Invasion
Kim YH et al.
Radiology 2009; 250:767-775"The diagnostic performance for overall lesion detection in patients with early gastric cancer was significantly higher with virtual gastroscopy than with 2D axial CT. Virtual gastroscopy showed a higher sensitivity for EGC than 2D axial CT."
Diagnostic Performance of Virtual Gastroscopy Using MDCT in Early Gastric Cancer Compared with 2D Axial CT: Focusing on Interobserver Variation
Kim JH et al.
AJR 2007; 189:299-305"Virtual gastroscopy showed excellent results with a good interobserver reliability for the detection of early gastric cancer compared with 2D axial CT."
Diagnostic Performance of Virtual Gastroscopy Using MDCT in Early Gastric Cancer Compared with 2D Axial CT: Focusing on Interobserver Variation
Kim JH et al.
AJR 2007; 189:299-305