Making the Transition
| Autor: | Tracy L. Matheson, Ashutosh V. Rao, Mark S. Parker, Kirk G. Jordan, Caroline D. Sherbourne, James A. Summa, George L. Miller, Michael J Landay |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Aortography Adolescent Aorta Thoracic Wounds Nonpenetrating Radiologic sign Blunt medicine.artery Humans Medicine Thoracic aorta Radiology Nuclear Medicine and imaging Aged Aged 80 and over Observer Variation medicine.diagnostic_test business.industry Vascular disease General Medicine Middle Aged Institutional review board medicine.disease Helical ct Acute Disease Costs and Cost Analysis Female Radiology Parallel imaging Tomography X-Ray Computed business |
| Zdroj: | American Journal of Roentgenology. 176:1267-1272 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.176.5.1761267 |
| Popis: | The purpose of this study was to show that helical CT could be used at our center in lieu of routine aortography to examine patients who have had serious blunt chest trauma. We also wanted to assess the potential savings of using CT to avoid unnecessary aortography.The institutional review board approved the parallel imaging-CT immediately followed by aortography-of patients presenting with blunt chest trauma between August 1997 and August 1998. To screen patients for potential aortic injuries, we performed parallel imaging on 142 patients, and these patients comprised our patient population. CT examinations of the patients were reviewed for signs of injury by radiologists who were unaware of each other's interpretations and the aortographic results. Findings of CT examinations were classified as negative, positive, or inconclusive for injury. Aortography was performed immediately after CT. The technical and professional fees for both transcatheter aortography and helical CT were also compared.Our combined kappa value for all CT interpretations was 0.714. The aortographic sensitivity and negative predictive value were both 100%. Likewise, the sensitivity and negative predictive value of CT were 100%. The total costs of performing aortography were estimated at approximately $402,900, whereas those for performing helical CT were estimated at $202,800.Helical CT has a sensitivity and negative predictive value equivalent to that of aortography. Using CT to eliminate the possibility of mediastinal hematoma and to evaluate the cause of an abnormal aortic contour in a trauma patient allows us to use aortography more selectively. Avoiding the performance of unnecessary aortography will expedite patient care and reduce costs. We report the results of our experience with CT and how our center successfully made this transition in the initial examination of patients with serious thoracic trauma. |
| Databáze: | OpenAIRE |
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