Table 3.
Overt GIB—CTA Protocol | Occult GIB or SBB—CTE Protocol | |
IV administration of contrast medium | 80–130 mL of high-concentration iodinated contrast medium (370–400 mgI/mL) | 80–130 mL of high-concentration iodinated contrast medium (370–400 mgI/mL) |
Speed of administration | The highest possible flow (3.5–4 mL/s) through an 18G cannula | The highest possible flow (3.5–4 mL/s) through an 18G cannula |
Normal saline | 40 mL of high-flow normal saline | 40 mL of high-flow normal saline |
Oral administration of contrast medium | Not recommended | 1350–1500 mL of fractionated neutral oral contrast agent starting about 1 h prior to the examination |
Scanned area | From the diaphragm to the pubic symphysis (possible extension to the chest) | From the diaphragm to the pubic symphysis |
Phases of acquisition | Multiphase CT technique: Without contrast or virtual no contrast Arterial phase (bolus tracking technique) Venous phase (70–90 s after injection) Optional late phase (5 min after injection) |
Multiphase CT technique: Without contrast or virtual no contrast Late arterial phase (10 s after bolus trigger) Enteric phase (50 s after injection) Late venous phase (90 s after injection) Alternative technique: split bolus protocols may be adopted |
Post-processing | 2.5–3 mm axial slices for each series (optional 1 mm axial) Coronal and sagittal reconstruction of 2.5–3 mm images (50% overlap) Optional maximum intensity projection and volumetric reconstruction |
2.5–3 mm axial slices for each series (optional 1 mm axial) Coronal and sagittal reconstruction of 2.5–3 mm images (50% overlap) Optional maximum intensity projection and volumetric reconstruction |
DECTA post-processing | 40–60 keV (i.e., virtual monoenergetic), iodine density, virtual non-contrast and standard mixed series | 40–60 keV (i.e., virtual monoenergetic), iodine density, virtual non-contrast and standard mixed series |