Universität zu Köln

Bremm, Johannes ORCID: 0000-0002-6081-1070, Henze, Jörn, Dratsch, Thomas ORCID: 0000-0003-4014-7763, Kloeckner, Roman, Maintz, David ORCID: 0000-0002-8942-3776 and dos Santos, Daniel Pinto ORCID: 0000-0003-4785-6394 (2025). CT-angiography in acute bleeding: Is a non-enhanced scan necessary? European Journal of Radiology, 187. pp. 1-5. Elsevier. ISSN 0720048X

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Abstract

[Artikel-Nr.: 112112] Objective: In clinical routine CT-angiography is frequently used to detect hemorrhage and to locate its source. Many centers use a triple phase protocol consisting of non-contrast, arterial and portal venous phase scan. The aim of this study was to clarify the added value of the non-contrast CT scan in detection of hemorrhage and to provide evidence for or against its usage. Materials & Methods: We retrospectively included all patients between 2014 and 2020 who underwent triphasic CT angiography for suspected bleeding and interventional angiography within 6 h of CT confirming bleeding. Two experienced observers re-evaluated all CT scans and established consensus on whether the bleeding could confidently be detected without the non-enhanced CT scan. Additionally, we recorded data on radiation exposure. Results: We included 75 patients (44 male, 31 female, median age 64 years) in the final dataset. Of all bleedings 33 (43 %) were GI bleedings. After consensus reading, non-enhanced CT scan was deemed helpful in only 3 cases (5.2 %) with all of these being GI bleeding. Non-enhanced series contributed substantially to the overall radiation exposure (mean DLPnon contrast 927.9 mGy*cm, mean DLParterial 631.3 mGy*cm, mean DLPportal venous 915.0 mGy*cm). Conclusion: Our results suggest that in the vast majority of cases non-contrast CT is not necessary to detect hemorrhage. Omission of non-enhanced CT scans results in relevant dose reduction. However, in few cases non- contrast scan can be helpful to exclude false positive findings in particular in suspected gastrointestinal bleeding.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Bremm, Johannes UNSPECIFIED https://orcid.org/0000-0002-6081-1070 UNSPECIFIED Henze, Jörn UNSPECIFIED UNSPECIFIED UNSPECIFIED Dratsch, Thomas UNSPECIFIED https://orcid.org/0000-0003-4014-7763 UNSPECIFIED Kloeckner, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED https://orcid.org/0000-0002-8942-3776 UNSPECIFIED dos Santos, Daniel Pinto UNSPECIFIED https://orcid.org/0000-0003-4785-6394 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-803524
Identification Number:	10.1016/j.ejrad.2025.112112
Journal or Publication Title:	European Journal of Radiology
Volume:	187
Page Range:	pp. 1-5
Number of Pages:	5
Date:	June 2025
Publisher:	Elsevier
ISSN:	0720048X
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Radiologische Diagnostik > Institut und Poliklinik für Radiologische Diagnostik
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Tomography, computed ; Acute bleeding ; Non-enhanced scan ; Radiation exposure English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80352