[Optimized imaging for suspected acute organ bleeding].

Abstract

Clinical/methodological problem: Contrast-enhanced computed tomography (CT) is the standard procedure for diagnosing acute organ bleeding. It provides rapid, precise and comprehensive visualization of the bleeding situation, which is crucial in emergency situations.

Radiological standard procedures: The examination is usually conducted in three phases: native, arterial and venous. These phases enable the precise identification and localization of the source of bleeding. The CT imaging is not only used to confirm the diagnosis but also aids in planning further treatment, facilitating targeted preparation for interventional radiologists, surgeons and endoscopists.

Methodological innovations: The possibilities for use of the technique in CT have significantly advanced in recent years. High-resolution CT scanners provide detailed images, which are particularly useful for detecting small bleedings and traumatic injuries. Multi-energy CT provides additional advantages by enabling virtual native examinations and mono-energetic image reconstructions, which enhance the visibility of iodine-based contrast agents. These technologies improve the sensitivity for detecting bleeding and enable a better characterization of the source of bleeding.

Recommendation for the practice: To optimize the CT diagnostics for bleeding, the use of a highly concentrated iodine contrast agent with a fast injection rate is recommended. Additionally, imaging data should be reconstructed with a slice thickness of 1-3 mm to achieve optimal diagnostic results. Multiplanar reconstructions are essential in all cases to ensure comprehensive imaging information. The combination of these advanced techniques and settings leads to improved diagnostics and treatment of acute organ bleeding.