Detection of bleeding in patients with major pelvic fractures: value of contrast-enhanced CT.

作者：Donald Cerva, Stuart E. Mirvis, Kathirkamanthan Shanmuganathan, I.M.G. Kelly, S. Osher Pais · 发表于：American Journal of Roentgenology · 年份：1996 · DOI：10.2214/ajr.166.1.8571861 · 被引用次数：121 · 研究领域：Pelvic and Acetabular Injuries、Abdominal Trauma and Injuries、Ureteral procedures and complications

OBJECTIVE: We performed a retrospective review of trauma patients who had undergone both pelvic angiography and preangiographic i.v. contrast-enhanced CT to determine whether CT can accurately demonstrate the presence or absence of pelvic bleeding in patients with multisystem trauma and major pelvic fractures. SUBJECTS AND METHODS: We reviewed the medical records and imaging studies of all patients, identified through a trauma radiology database, who had undergone pelvic angiography and preangiographic contrast-enhanced CT during a 48-month period. Results of CT scans were recorded by consensus interpretation of three radiologists without knowledge of angiographic findings. Sites of contrast material extravasation seen on CT scans were noted and compared with sites of bleeding or vascular injury identified by selective pelvic angiography. RESULTS: Thirty patients with blunt trauma and pelvic fractures underwent both pelvic angiography and preangiographic CT studies. Findings on pelvic angiograms were positive at 26 sites in 19 patients and included contrast agent extravasation at 23 sites and vessel abnormalities without extravasation at three sites. Preangiographic pelvic CT scans showed contrast agent extravasation at 20 sites in 16 patients. Three patients had no contrast agent extravasation demonstrated by CT but had bleeding demonstrated by angiography. CT detected bleeding in 16 of 19 patients who had extravasation or vascular injury demonstrated by angiography, for a s...