Computed tomography angiography provides limited benefit in the evaluation of patients with pelvic fractures

Chih Yuan Fu, Shang Yu Wang, Chien Hung Liao, Shih Ching Kang, Yu Pao Hsu, Being Chuan Lin, Kuo Ching Yuan, Chun Hsiang Ouyang

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction Computed tomography angiography (CTA) has been applied in imaging studies for the assessment of most abdominal and pelvic injuries in some trauma centers. However, in most institutions, CTA is not routinely performed as part of the computed tomography scan protocol. In this study, we aimed to assess the efficiency of CTA in the evaluation of patients with pelvic fractures.

Materials and methods During the study period, patients with pelvic fracture were retrospectively analyzed. In addition to conventional computed tomography scanning that includes only the single venous phase, CTA with an additional arterial phase was used to obtain more information regarding vascular injuries. Further angiographic examination was performed in the patients with positive results in either the arterial or venous phase. The sensitivity and specificity of the multiphasic CTA images in the evaluation of active arterial hemorrhage were investigated. Furthermore, the results obtained for the arterial and venous phases were also combined to evaluate associated active arterial hemorrhage.

Results A total of 144 patients with pelvic fractures who underwent CTA were enrolled in this study. Of these patients, 49 (34.0%) had active arterial hemorrhage. The sensitivities of the venous and arterial phase CTA images in the evaluation of active arterial hemorrhage were 100% (49/49) and 89.8% (44/49), respectively. Furthermore, all of the patients with positive results based on the arterial phase images were included in the group of patients with positive results based on the venous phase images. Although there were 4 patients without active arterial hemorrhage based on the angiographic examination, they still underwent embolization.

Conclusions In the management of patients with pelvic fractures, CTA provides limited benefits in the evaluation of the active arterial hemorrhage. The additional arterial phase may be helpful for distinguishing between arterial and venous hemorrhage. However, this study showed that subsequent treatment was not changed.

Original languageEnglish
Pages (from-to)1220-1224
Number of pages5
JournalAmerican Journal of Emergency Medicine
Volume32
Issue number10
DOIs
Publication statusPublished - Oct 1 2014
Externally publishedYes

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Hemorrhage
Tomography
Computed Tomography Angiography
Abdominal Injuries
Trauma Centers
Vascular System Injuries
Sensitivity and Specificity
Therapeutics

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Computed tomography angiography provides limited benefit in the evaluation of patients with pelvic fractures. / Fu, Chih Yuan; Wang, Shang Yu; Liao, Chien Hung; Kang, Shih Ching; Hsu, Yu Pao; Lin, Being Chuan; Yuan, Kuo Ching; Ouyang, Chun Hsiang.

In: American Journal of Emergency Medicine, Vol. 32, No. 10, 01.10.2014, p. 1220-1224.

Research output: Contribution to journalArticle

Fu, Chih Yuan ; Wang, Shang Yu ; Liao, Chien Hung ; Kang, Shih Ching ; Hsu, Yu Pao ; Lin, Being Chuan ; Yuan, Kuo Ching ; Ouyang, Chun Hsiang. / Computed tomography angiography provides limited benefit in the evaluation of patients with pelvic fractures. In: American Journal of Emergency Medicine. 2014 ; Vol. 32, No. 10. pp. 1220-1224.
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abstract = "Introduction Computed tomography angiography (CTA) has been applied in imaging studies for the assessment of most abdominal and pelvic injuries in some trauma centers. However, in most institutions, CTA is not routinely performed as part of the computed tomography scan protocol. In this study, we aimed to assess the efficiency of CTA in the evaluation of patients with pelvic fractures.Materials and methods During the study period, patients with pelvic fracture were retrospectively analyzed. In addition to conventional computed tomography scanning that includes only the single venous phase, CTA with an additional arterial phase was used to obtain more information regarding vascular injuries. Further angiographic examination was performed in the patients with positive results in either the arterial or venous phase. The sensitivity and specificity of the multiphasic CTA images in the evaluation of active arterial hemorrhage were investigated. Furthermore, the results obtained for the arterial and venous phases were also combined to evaluate associated active arterial hemorrhage.Results A total of 144 patients with pelvic fractures who underwent CTA were enrolled in this study. Of these patients, 49 (34.0{\%}) had active arterial hemorrhage. The sensitivities of the venous and arterial phase CTA images in the evaluation of active arterial hemorrhage were 100{\%} (49/49) and 89.8{\%} (44/49), respectively. Furthermore, all of the patients with positive results based on the arterial phase images were included in the group of patients with positive results based on the venous phase images. Although there were 4 patients without active arterial hemorrhage based on the angiographic examination, they still underwent embolization.Conclusions In the management of patients with pelvic fractures, CTA provides limited benefits in the evaluation of the active arterial hemorrhage. The additional arterial phase may be helpful for distinguishing between arterial and venous hemorrhage. However, this study showed that subsequent treatment was not changed.",
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AU - Wang, Shang Yu

AU - Liao, Chien Hung

AU - Kang, Shih Ching

AU - Hsu, Yu Pao

AU - Lin, Being Chuan

AU - Yuan, Kuo Ching

AU - Ouyang, Chun Hsiang

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N2 - Introduction Computed tomography angiography (CTA) has been applied in imaging studies for the assessment of most abdominal and pelvic injuries in some trauma centers. However, in most institutions, CTA is not routinely performed as part of the computed tomography scan protocol. In this study, we aimed to assess the efficiency of CTA in the evaluation of patients with pelvic fractures.Materials and methods During the study period, patients with pelvic fracture were retrospectively analyzed. In addition to conventional computed tomography scanning that includes only the single venous phase, CTA with an additional arterial phase was used to obtain more information regarding vascular injuries. Further angiographic examination was performed in the patients with positive results in either the arterial or venous phase. The sensitivity and specificity of the multiphasic CTA images in the evaluation of active arterial hemorrhage were investigated. Furthermore, the results obtained for the arterial and venous phases were also combined to evaluate associated active arterial hemorrhage.Results A total of 144 patients with pelvic fractures who underwent CTA were enrolled in this study. Of these patients, 49 (34.0%) had active arterial hemorrhage. The sensitivities of the venous and arterial phase CTA images in the evaluation of active arterial hemorrhage were 100% (49/49) and 89.8% (44/49), respectively. Furthermore, all of the patients with positive results based on the arterial phase images were included in the group of patients with positive results based on the venous phase images. Although there were 4 patients without active arterial hemorrhage based on the angiographic examination, they still underwent embolization.Conclusions In the management of patients with pelvic fractures, CTA provides limited benefits in the evaluation of the active arterial hemorrhage. The additional arterial phase may be helpful for distinguishing between arterial and venous hemorrhage. However, this study showed that subsequent treatment was not changed.

AB - Introduction Computed tomography angiography (CTA) has been applied in imaging studies for the assessment of most abdominal and pelvic injuries in some trauma centers. However, in most institutions, CTA is not routinely performed as part of the computed tomography scan protocol. In this study, we aimed to assess the efficiency of CTA in the evaluation of patients with pelvic fractures.Materials and methods During the study period, patients with pelvic fracture were retrospectively analyzed. In addition to conventional computed tomography scanning that includes only the single venous phase, CTA with an additional arterial phase was used to obtain more information regarding vascular injuries. Further angiographic examination was performed in the patients with positive results in either the arterial or venous phase. The sensitivity and specificity of the multiphasic CTA images in the evaluation of active arterial hemorrhage were investigated. Furthermore, the results obtained for the arterial and venous phases were also combined to evaluate associated active arterial hemorrhage.Results A total of 144 patients with pelvic fractures who underwent CTA were enrolled in this study. Of these patients, 49 (34.0%) had active arterial hemorrhage. The sensitivities of the venous and arterial phase CTA images in the evaluation of active arterial hemorrhage were 100% (49/49) and 89.8% (44/49), respectively. Furthermore, all of the patients with positive results based on the arterial phase images were included in the group of patients with positive results based on the venous phase images. Although there were 4 patients without active arterial hemorrhage based on the angiographic examination, they still underwent embolization.Conclusions In the management of patients with pelvic fractures, CTA provides limited benefits in the evaluation of the active arterial hemorrhage. The additional arterial phase may be helpful for distinguishing between arterial and venous hemorrhage. However, this study showed that subsequent treatment was not changed.

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