Using contrast-enhanced helical CT to visualize arterial extravasation after blunt abdominal trauma: incidence and organ distribution
| Autor: | Dorcas C, Yao, R Brooke, Jeffrey, Stuart E, Mirvis, Arnold, Weekes, Michael P, Federle, Connie, Kim, Michael J, Lane, Priya, Prabhakar, Randall, Radin, Philip W, Ralls |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Abdominal Injuries Wounds Nonpenetrating Blunt medicine Humans Radiology Nuclear Medicine and imaging Embolization Prospective Studies Aged Aged 80 and over medicine.diagnostic_test business.industry Vascular disease Angiography General Medicine Middle Aged medicine.disease Embolization Therapeutic Extravasation Radiographic Image Enhancement Viscera medicine.anatomical_structure Abdominal trauma Abdomen Female Radiology business Tomography X-Ray Computed Artery Extravasation of Diagnostic and Therapeutic Materials |
| Zdroj: | AJR. American journal of roentgenology. 178(1) |
| ISSN: | 0361-803X |
| Popis: | We evaluated the incidence and organ distribution of arterial extravasation identified using contrast-enhanced helical CT in patients who had sustained abdominal visceral injuries and pelvic fractures after blunt trauma.Five hundred sixty-five consecutive patients from four level I trauma centers who had CT scans showing abdominal visceral injuries or pelvic fractures were included in this series. The presence or absence of arterial extravasation, as well as the anatomic sites of arterial extravasation, was noted. We obtained clinical follow-up data, including surgical or angiographic findings.In our series, 104 (18.4%) of 565 patients had arterial extravasation. Of the 104 patients, 81 (77.9%) underwent surgery, embolization, or both. The combined rate of surgery or embolization in patients with arterial extravasation was statistically higher than expected at all four institutions (p0.001). The spleen was the most common organ injured, occurring in 277 (49.0%) of 565 patients, and arterial extravasation occurred in 49 (17.7%) of 277 patients with splenic injury. Several other visceral injuries were associated with arterial extravasation, including hepatic, renal, adrenal, and mesenteric injuries.Based on the limited reports of arterial extravasation in the nonhelical CT literature, the percentage (18%) of clinically stable patients in our study with CT scans showing arterial extravasation was higher than anticipated. This finding likely reflects the improved diagnostic capability of helical CT. Although the spleen and liver were the organs most commonly associated with arterial extravasation, radiologists should be aware that arterial extravasation may be associated with several other visceral injuries. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|