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Pelvic CT angiography: application to blunt trauma using 64MDCT

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Abstract

The evolution of multi-row detector computed tomography (MDCT) technology has resulted in evolving applications of CT angiography (CTA) in the trauma setting. In patients with significant blunt pelvic injuries, the immediate diagnosis and characterization of vascular injuries is of significant import given their morbidity and mortality in this patient population. The application of MDCT technology, specifically 64MDCT, to pelvic CTA is useful in evaluating for potential vascular injuries and may be integrated into admission trauma imaging in order to triage patients with blunt pelvic trauma to appropriate emergent intervention. This paper will discuss the use of pelvic CTA in blunt pelvic trauma and its utility in detecting and characterizing vascular injury, including the differentiation of arterial from venous hemorrhage. Protocol considerations in pelvic CTA using 64MDCT technology will be detailed as well as the integration of pelvic CTA into torso CT trauma protocols.

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References

  1. Ben-Menachem Y, Coldwell DM, Young JW, Burgess AR (1991) Hemorrhage associated with pelvic fractures: causes, diagnosis, and emergent management. AJR Am J Roentgenol 157:1005–1014

    PubMed  CAS  Google Scholar 

  2. Biffl WL, Smith WR, Moore EE et al (2001) Evolution of a multidisciplinary clinical pathway for the management of unstable patients with pelvic fractures. Ann Surg 233:843–850

    Article  PubMed  CAS  Google Scholar 

  3. Blackmore CC, Jurkovich GJ, Linnau KF, Cummings P, Hoffer EK, Rivara FP (2003) Assessment of volume of hemorrhage and outcome from pelvic fracture. Arch Surg 138:504–508

    Article  PubMed  Google Scholar 

  4. Evers BM, Cryer HM, Miller FB (1989) Pelvic fracture hemorrhage. Priorities in management. Arch Surg 124:422–424

    PubMed  CAS  Google Scholar 

  5. Hagiwara A, Minakawa K, Fukushima H, Murata A, Masuda H, Shimazaki S (2003) Predictors of death in patients with life-threatening pelvic hemorrhage after successful transcatheter arterial embolization. J Trauma 55:696–703

    Article  PubMed  Google Scholar 

  6. Pereira SJ, O’Brien DP, Luchette FA (2000) Dynamic helical computed tomography scan accurately detects hemorrhage in patients with pelvic fracture. Surgery 128:678–685

    Article  PubMed  CAS  Google Scholar 

  7. Sheridan MK, Blackmore CC, Linnau KF, Hoffer EK, Lomoschitz F, Jurkovich GJ (2002) Can CT predict the source of arterial hemorrhage in patients with pelvic fractures? Emerg Radiol 9:188–194

    PubMed  Google Scholar 

  8. Weishaupt D, Grozaj AM, Willmann JK, Roos JE, Hilfiker PR, Marincek B (2002) Traumatic injuries: imaging of abdominal and pelvic injuries. Eur Radiol 12:1295–1311

    Article  PubMed  Google Scholar 

  9. Yoon W, Kim JK, Jeong YY, Seo JJ, Park JG, Kang HK (2004) Pelvic arterial hemorrhage in patients with pelvic fractures: detection with contrast-enhanced CT. Radiographics 24:1591–1605

    Article  PubMed  Google Scholar 

  10. Poole GV, Ward EF, Muakkassa FF, Hsu HS, Griswold JA, Rhodes RS (1991) Pelvic fracture from major blunt trauma. Outcome is determined by associated injuries. Ann Surg 213:532–538

    Article  PubMed  CAS  Google Scholar 

  11. Agolini SF, Shah K, Jaffe J, Newcomb J, Rhodes M, Reed JF 3rd (1997) Arterial embolization is a rapid and effective technique for controlling pelvic fracture hemorrhage. J Trauma 43:395–399

    Article  PubMed  CAS  Google Scholar 

  12. Stephen DJ, Kreder HJ, Day AC et al (1999) Early detection of arterial bleeding in acute pelvic trauma. J Trauma 47:638–642

    Article  PubMed  CAS  Google Scholar 

  13. Brasel KJ, Pham K, Yang H, Christensen R, Weigelt JA (2007) Significance of contrast extravasation in patients with pelvic fracture. J Trauma 62:1149–1152 2007

    Article  PubMed  Google Scholar 

  14. Brown CV, Kasotakis G, Wilcox A, Rhee P, Salim A, Demetriades D (2005) Does pelvic hematoma on admission computed tomography predict active bleeding at angiography for pelvic fracture? Am Surg 71:759–762

    PubMed  Google Scholar 

  15. Cerva DS Jr, Mirvis SE, Shanmuganathan K, Kelly IM, Pais SO (1996) Detection of bleeding in patients with major pelvic fractures: value of contrast-enhanced CT. AJR Am J Roentgenol 166:131–135

    PubMed  Google Scholar 

  16. Falchi M, Rollandi GA (2004) CT of pelvic fractures. Eur J Radiol 50:96–105

    Article  PubMed  Google Scholar 

  17. McCort J, Mindelzun RE (1994) Bladder injury and pelvic fractures. Emerg Radiol 1:47–51 1994

    Article  Google Scholar 

  18. Shanmuganathan K, Mirvis SE, Sover ER (1993) Value of contrast-enhanced CT in detecting active hemorrhage in patients with blunt abdominal or pelvic trauma. AJR Am J Roentgenol 161:65–69

    PubMed  CAS  Google Scholar 

  19. Anderson SW, Soto JA, Lucey BC, Burke PA, Hirsch EF, Rhea JT (2008) Blunt trauma: feasibility and clinical utility of pelvic CT angiography performed with 64-detector row CT. Radiology 246:410–419

    Article  PubMed  Google Scholar 

  20. Kertesz JL, Anderson SW, Murakami AM, Pieroni S, Rhea JT, Soto JA (2009) Detection of vascular injuries in patients with blunt pelvic trauma by using 64-channel multidetector CT. Radiographics 29:151–164

    Article  PubMed  Google Scholar 

  21. John TR, Krauss B, Sedlmair M (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517

    Article  PubMed  Google Scholar 

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Correspondence to Jennifer Uyeda.

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Uyeda, J., Anderson, S.W., Kertesz, J. et al. Pelvic CT angiography: application to blunt trauma using 64MDCT. Emerg Radiol 17, 131–137 (2010). https://doi.org/10.1007/s10140-009-0825-7

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  • DOI: https://doi.org/10.1007/s10140-009-0825-7

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