Computed tomography in intestinal angiodysplasia diagnosis using clinical cases example

Intestinal angiodysplasia is a vascular pathology of the intestinal wall, one of the causes of gastrointestinal bleeding, the severity of which can vary from latent to life-threatening. Patients of this group, according to vital indications, as a rule, are admitted to general surgical hospitals, where, due to the rare occurrence of pathology, there are no well-developed treatment and diagnostic algorithms, which leads to misrecognition of the source of bleeding and unreasonable surgical interventions. To demonstrate the possibilities of computed tomography with bolus intravenous contrast in the detection of intestinal angiodysplasia. Patients sought medical help in a hospital with recurrent gastrointestinal bleeding. Abdominal and pelvic CT using intravenous bolus contrast and multi-phase scanning was performed on 64- and 128-slice CT scanners. Post-processing included analysis of standard reconstructions, MIP and 3D VRT algorithms. Cases represent the main angiographic signs of intestinal angiodysplasia, such as: abnormal vascular network in the intestinal wall, dilatation of the great vessels supplying angiodysplasia, early contrast enhancement of the efferent vein. Evaluation of the MIP and 3D VRT algorithms makes it possible to identify these pathological changes more confidently. To date, computed tomography with bolus intravenous contrast is the most accessible non-invasive diagnostic method that allows to identify and localize intestinal angiodysplasia and, in combination with endoscopic investigative methods, confirm the diagnosis and exclude other pathology characterized by a similar clinical presentation, which helps to choose the correct treatment tactics.

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