title: Volume-rendered hemorrhage-responsible arteriogram created by 64 multidetector-row CT during aortography: utility for catheterization in transcatheter arterial embolization for acute arterial bleeding.
abstract: Aortography for detecting hemorrhage is limited when determining the catheter treatment strategy because the artery responsible for hemorrhage commonly overlaps organs and non-responsible arteries. Selective catheterization of untargeted arteries would result in repeated arteriography, large volumes of contrast medium, and extended time. A volume-rendered hemorrhage-responsible arteriogram created with 64 multidetector-row CT (64MDCT) during aortography (MDCTAo) can be used both for hemorrhage mapping and catheter navigation. The MDCTAo depicted hemorrhage in 61 of 71 cases of suspected acute arterial bleeding treated at our institute in the last 3 years. Complete hemostasis by embolization was achieved in all cases. The hemorrhage-responsible arteriogram was used for navigation during catheterization, thus assisting successful embolization. Hemorrhage was not visualized in the remaining 10 patients, of whom 6 had a pseudoaneurysm in a visceral artery; 1 with urinary bladder bleeding and 1 with chest wall hemorrhage had gaze tamponade; and 1 with urinary bladder hemorrhage and 1 with uterine hemorrhage had spastic arteries. Six patients with pseudoaneurysm underwent preventive embolization and the other 4 patients were managed by watchful observation. MDCTAo has the advantage of depicting the arteries responsible for hemoptysis, whether from the bronchial arteries or other systemic arteries, in a single scan. MDCTAo is particularly useful for identifying the source of acute arterial bleeding in the pancreatic arcade area, which is supplied by both the celiac and superior mesenteric arteries. In a case of pelvic hemorrhage, MDCTAo identified the responsible artery from among numerous overlapping visceral arteries that branched from the internal iliac arteries. In conclusion, a hemorrhage-responsible arteriogram created by 64MDCT immediately before catheterization is useful for deciding the catheter treatment strategy for acute arterial bleeding.
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Minamiguchi
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kawai
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ikoma
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sanda
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Nakata
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Tanaka
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Motoki
authors.initials: M
authors.lastname: Nakai
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Sonomura
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Murotani
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Seiki
authors.initials: S
authors.lastname: Hosokawa
authors.affiliation: Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8510 Japan.
authors.forename: Tadayoshi
authors.initials: T
authors.lastname: Nishioku
keywords: Acute arterial bleeding; CT during aortography; Multidetector-row CT; Transcatheter arterial embolization; Volume-rendered hemorrhage-responsible arteriogram