Accuracy of helical computed tomographic angiography for the diagnosis of colonic angiodysplasia.
OBJECTIVE
The diagnosis of colonic angiodysplasia is often challenging and relies on endoscopy or catheter angiography. We investigated whether computed tomographic angiography (CTA) contributes to the diagnosis of colonic angiodysplasia.


METHODS
Twenty-eight patients with suspected bleeding from colonic angiodysplasia were prospectively evaluated. Gastrointestinal bleeding was investigated by colonoscopy plus visceral angiography and by CTA. The level of agreement between CTA and the former procedures was determined.


RESULTS
CTA images of diagnostic quality were obtained in 26 patients. Eighteen patients were diagnosed with colonic angiodysplasia by colonoscopy plus visceral angiography, and 14 by CTA (kappa = 0.68; P < 0.001). Sensitivity, specificity, and positive predictive values of CTA for detection of colonic angiodysplasia were 70%, 100%, and 100%, respectively. CTA signs including accumulation of vessels in the colonic wall, early filling vein, and supplying enlarged artery were present in 55%, 50%, and 22% of cases, respectively. None of these signs were present in the 8 patients with obscure gastrointestinal bleeding and negative diagnostic investigation of the digestive tract.


CONCLUSIONS
CTA is a sensitive, specific, well-tolerated, and minimally invasive tool for the diagnosis of colonic angiodysplasia.
Digestive System Research Unit, Hospital General Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
F
F
Junquera
S
S
Quiroga
E
E
Saperas
M
M
Pérez-Lafuente
S
S
Videla
A
A
Alvarez-Castells
J R
JR
Miró
J R
JR
Malagelada
D000368:Aged; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000000981:diagnostic imaging*; D000792:Angiography / Q000379:methods / Q000592:standards*; D003106:Colon / Q000098:blood supply; D003108:Colonic Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000592:standards*