Extravasated contrast volumetric assessment on computed tomography angiography in gastrointestinal bleeding: A useful predictor of positive angiographic findings

Figure 4 Example case of a 71-year-old man with ileal gastrointestinal bleeding detected at computed tomography angiography and evaluated with a semiautomated software (bleeding rate: 0. 585 mL/min) and confirmed by catheter angiography (concordance group). A: Computed tomography angiography (CTA) in the arterial phase showing jejunal gastrointestinal bleeding (GIB) on axial view; B: CTA in the venous phase showing jejunal GIB on axial view; C: GIB volume evaluation in the arterial phase of axial CTA with a semiautomatic software on a dedicated workstation. Bleeding volume was 0.160 mL; D: GIB volume evaluation in the venous phase of axial CTA with a semiautomatic software. Bleeding volume in the venous phase was 5.397 mL; E: GIB volume evaluation in the arterial phase of coronal CTA; F: GIB volume evaluation in the venous phase of coronal CTA; G: GIB volume evaluation in the arterial phase of sagittal CTA; H: GIB volume evaluation in the arterial phase of sagittal CTA; I: Catheter angiography of superior mesenteric artery showing signs of bleeding; J and K: Selective and super-selective angiograms of ileal branches of the superior mesenteric artery showing signs of bleeding; L: Transarterial embolization with mechanical agents; M: Final angiography showing effective treatment with no signs of bleeding.