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Emergency Radiology

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01-02-2021 | Computed Tomography | Original Article

Do we really need the arterial phase on CT in pelvic trauma patients?

Authors: Johannes Clemens Godt, Torsten Eken, Anselm Schulz, Kjetil Øye, Thijs Hagen, Johann Baptist Dormagen

Published in: Emergency Radiology | Issue 1/2021

Abstract

Purpose

To evaluate whether an arterial phase scan improves the diagnostic performance of computed tomography to identify pelvic trauma patients who received angiographic intervention on demand of the trauma surgeon.

Methods

This retrospective single-center study was performed at an academic Scandinavian trauma center with approximately 2000 trauma admissions annually. Pelvic trauma patients with arterial and portal venous phase CT from 2009 to 2015 were included. The patients were identified from the institutional trauma registry. Images were interpreted by two radiologists with more than 10 years of trauma radiology experience. Positive findings for extravasation on portal venous phase alone or on both arterial and portal venous phase were compared, with angiographic intervention as clinical outcome.

Results

One hundred fifty-seven patients (54 females, 103 males) with a median age of 45 years were enrolled. Sixteen patients received angiographic intervention. Positive CT findings on portal venous phase only had a sensitivity and specificity of 62% and 86%, vs. 56% and 93% for simultaneous findings on arterial and portal venous phase. Specificity was significantly higher for positive findings in both phases compared with portal venous phase only. Applying a threshold > 0.9 cm of extravasation diameter to portal venous phase only resulted in sensitivity and specificity identical to those of both phases.

Conclusion

Arterial phase scan in addition to portal venous phase scan did not improve patient selection for angiography. Portal venous phase extravasation size alone may be used as an imaging-based biomarker of the need for angiographic intervention.

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Title: Do we really need the arterial phase on CT in pelvic trauma patients?
Authors: Johannes Clemens Godt
Torsten Eken
Anselm Schulz
Kjetil Øye
Thijs Hagen
Johann Baptist Dormagen
Publication date: 01-02-2021
Publisher: Springer International Publishing
Keywords: Computed Tomography
Angiography
Computed Tomography
Pelvic Trauma
Published in: Emergency Radiology / Issue 1/2021
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI: https://doi.org/10.1007/s10140-020-01820-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Do we really need the arterial phase on CT in pelvic trauma patients?

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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