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Pelvic CT angiography: application to blunt trauma using 64MDCT

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An Erratum to this article was published on 04 June 2010

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 are 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 review 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. 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(6):843–850

    Article  CAS  PubMed  Google Scholar 

  2. Brasel KJ, Pham K, Yang H, Christensen R, Weigelt JA (2007) Significance of contrast extravasation in patients with pelvic fracture. J Trauma 62(5):1149–1152

    Article  PubMed  Google Scholar 

  3. Brown JJ, Greene FL, McMillin RD (1984) Vascular injuries associated with pelvic fractures. Am Surg 50(3):150–154

    CAS  PubMed  Google Scholar 

  4. Falchi M, Rollandi GA (2004) CT of pelvic fractures. Eur J Radiol 50(1):96–105

    Article  PubMed  Google Scholar 

  5. Hamilton JD, Kumaravel M, Censullo ML, et al. (2008) Multidetector CT evaluation of active extravasation in blunt abdominal and pelvic trauma patients. Radiographics 28(6):1603–1616

    Article  PubMed  Google Scholar 

  6. Jeffrey RB Jr, Cardoza JD, Olcott EW (1991) Detection of active intraabdominal arterial hemorrhage: value of dynamic contrast-enhanced CT. AJR Am J Roentgenol 156(4):725–729

    PubMed  Google Scholar 

  7. Pereira SJ, O’Brien DP, Luchette FA, et al. (2000) Dynamic helical computed tomography scan accurately detects hemorrhage in patients with pelvic fracture. Surgery 128(4):678–685

    Article  CAS  PubMed  Google Scholar 

  8. Poole GV, Ward EF, Muakkassa FF, et al. (1991) Pelvic fracture from major blunt trauma. Outcome is determined by associated injuries. Ann Surg 213(6):532–538

    Article  CAS  PubMed  Google Scholar 

  9. 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(1):65–69

    CAS  PubMed  Google Scholar 

  10. Sheridan MK, Blackmore CC, Linnau KF, et al. (2002) Can CT predict the source of arterial hemorrhage in patients with pelvic fractures? Emerg Radiol 9(4):188–194

    PubMed  Google Scholar 

  11. Shuman WP (1997) CT of blunt abdominal trauma in adults. Radiology 205(2):297–306

    CAS  PubMed  Google Scholar 

  12. Willmann JK, Roos JE, Platz A, et al. (2002) Multidetector CT: detection of active hemorrhage in patients with blunt abdominal trauma. AJR Am J Roentgenol 179(2):437–444

    PubMed  Google Scholar 

  13. Yao DC, Jeffrey RB Jr, Mirvis SE, et al. (2002) Using contrast-enhanced helical CT to visualize arterial extravasation after blunt abdominal trauma: incidence and organ distribution. AJR Am J Roentgenol 178(1):17–20

    PubMed  Google Scholar 

  14. Yoon W, Kim JK, Jeong YY, et al. (2004) Pelvic arterial hemorrhage in patients with pelvic fractures: detection with contrast-enhanced CT. Radiographics 24(6):1591–1605

    Article  PubMed  Google Scholar 

  15. Stephen DJ, Kreder HJ, Day AC, et al. (1999) Early detection of arterial bleeding in acute pelvic trauma. J Trauma 47(4):638–642

    Article  CAS  PubMed  Google Scholar 

  16. 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(5):1005–1014

    CAS  PubMed  Google Scholar 

  17. Rossaint R, Cerny V, Coats TJ, et al. (2006) Key issues in advanced bleeding care in trauma. Shock 26(4):322–331

    Article  PubMed  Google Scholar 

  18. 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(1):131–135

    PubMed  Google Scholar 

  19. Maturen KE, Adusumilli S, Blane CE, et al. (2007) Contrast-enhanced CT accurately detects hemorrhage in torso trauma: direct comparison with angiography. J Trauma 62(3):740–745

    Article  PubMed  Google Scholar 

  20. Romano L, Pinto A, De Lutio Di Castelguidone E, et al. (2000) Spiral computed tomography in the assessment of vascular lesions of the pelvis due to blunt trauma. Radiol Med 100(1–2):29–32

    CAS  PubMed  Google Scholar 

  21. Schoepf UJ, Becker CR, Hofmann LK, et al. (2003) Multislice CT angiography. Eur Radiol 13(8):1946–1961

    Article  PubMed  Google Scholar 

  22. Vrtiska TJ, Fletcher JG, McCollough CH (2005) State-of-the-art imaging with 64-channel multidetector CT angiography. Perspect Vasc Surg Endovasc Ther 17(1):3–8

    Article  PubMed  Google Scholar 

  23. Anderson SW, Soto JA, Lucey BC, et al. (2008) Blunt trauma: feasibility and clinical utility of pelvic CT angiography performed with 64-detector row CT. Radiology 246(2):410–419

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Boston University Medical Center, 715 Albany Street, Boston, MA, FGH-3007, USA

    Jennifer Uyeda, Stephan W. Anderson, Jennifer Kertesz, James T. Rhea & Jorge A. Soto

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  1. Jennifer Uyeda
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  2. Stephan W. Anderson
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  3. Jennifer Kertesz
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  4. James T. Rhea
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  5. Jorge A. Soto
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Corresponding author

Correspondence to Jennifer Uyeda.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00261-010-9629-1.

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Uyeda, J., Anderson, S.W., Kertesz, J. et al. Pelvic CT angiography: application to blunt trauma using 64MDCT. Abdom Imaging 35, 280–286 (2010). https://doi.org/10.1007/s00261-009-9525-8

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