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The additional value of the arterial phase in the CT assessment of liver vascular injuries after high-energy blunt trauma
Purpose In the literature, no consensus exists about which CT protocol is to be adopted in patients who underwent high-energy blunt trauma. The aim of the study is to evaluate the additional value of the arterial phase in the CT assessment of vascular injuries of the liver. Methods Admission CT exam...
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| Published in: | Emergency radiology 2019-12, Vol.26 (6), p.647-654 |
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| container_title | Emergency radiology |
| container_volume | 26 |
| creator | Iacobellis, Francesca Scaglione, Mariano Brillantino, Antonio Scuderi, Maria Giuseppina Giurazza, Francesco Grassi, Roberto Noschese, Giuseppe Niola, Raffaella Al Zuhir, Naail Yarub Sulaiman Romano, Luigia |
| description | Purpose
In the literature, no consensus exists about which CT protocol is to be adopted in patients who underwent high-energy blunt trauma. The aim of the study is to evaluate the additional value of the arterial phase in the CT assessment of vascular injuries of the liver.
Methods
Admission CT examinations for patients with traumatic injury of the liver due to high-energy blunt trauma, performed between 2011 and 2017 in two major trauma centres, were retrospectively reviewed. Images were analysed for presence or absence of liver parenchymal injury, intrahepatic contained vascular injuries and active bleeding in the arterial and portal venous phase of the CT study.
Results
Two hundred twelve patients have been identified. Parenchymal injuries were detected as isolated in 90.6% of cases, whereas they were associated with vascular injuries in 9.4% of cases: contained vascular injuries in 3.3% and active bleeding in 6.1%. Out of all parenchymal injuries detected on the CT portal venous phase, 90.5% were also detectable in the arterial phases (
p
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| doi_str_mv | 10.1007/s10140-019-01714-y |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2312273759</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2312273759</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-ad73583fdfef5c568fbf86ada577f5dbb0f89feaaec9c7cc27191c5c35a7888b3</originalsourceid><addsrcrecordid>eNp9kUuLFDEUhYMozss_4EICbmZTmmcltZRGR2HATc863ErddFdTjzapDNS_n_T0qODCRZLLyXdOIIeQ95x94oyZz4kzrljFeFOW4apaX5FLrqStyqZfl5kZVknG1AW5SunAGKub2r4lF5IrpWrLLsm63SOFruuXfp5goI8wZKRzoMtJjwvGvqjHPSSk_fSsbrYUUsKURpyWEzr0jxiLM_k8QCzYIcceE4VQ7HTf7_YVThh3K22HXCxLhDzCDXkTYEj47uW8Jg_fvm4336v7n3c_Nl_uK68UXyrojNRWhi5g0F7XNrTB1tCBNiborm1ZsE1AAPSNN94LwxvutZcajLW2ldfk9px7jPOvjGlxY588DgNMOOfkhORCGGl0U9CP_6CHOcfyLYUSxkohGqELJc6Uj3NKEYM7xn6EuDrO3KkYdy7GlWLcczFuLaYPL9G5HbH7Y_ndRAHkGUjlatph_Pv2f2KfAFSfm3Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2278322925</pqid></control><display><type>article</type><title>The additional value of the arterial phase in the CT assessment of liver vascular injuries after high-energy blunt trauma</title><source>Springer Nature</source><creator>Iacobellis, Francesca ; Scaglione, Mariano ; Brillantino, Antonio ; Scuderi, Maria Giuseppina ; Giurazza, Francesco ; Grassi, Roberto ; Noschese, Giuseppe ; Niola, Raffaella ; Al Zuhir, Naail Yarub Sulaiman ; Romano, Luigia</creator><creatorcontrib>Iacobellis, Francesca ; Scaglione, Mariano ; Brillantino, Antonio ; Scuderi, Maria Giuseppina ; Giurazza, Francesco ; Grassi, Roberto ; Noschese, Giuseppe ; Niola, Raffaella ; Al Zuhir, Naail Yarub Sulaiman ; Romano, Luigia</creatorcontrib><description>Purpose
In the literature, no consensus exists about which CT protocol is to be adopted in patients who underwent high-energy blunt trauma. The aim of the study is to evaluate the additional value of the arterial phase in the CT assessment of vascular injuries of the liver.
Methods
Admission CT examinations for patients with traumatic injury of the liver due to high-energy blunt trauma, performed between 2011 and 2017 in two major trauma centres, were retrospectively reviewed. Images were analysed for presence or absence of liver parenchymal injury, intrahepatic contained vascular injuries and active bleeding in the arterial and portal venous phase of the CT study.
Results
Two hundred twelve patients have been identified. Parenchymal injuries were detected as isolated in 90.6% of cases, whereas they were associated with vascular injuries in 9.4% of cases: contained vascular injuries in 3.3% and active bleeding in 6.1%. Out of all parenchymal injuries detected on the CT portal venous phase, 90.5% were also detectable in the arterial phases (
p
< 0.0001). All of the contained vascular injuries were visible in the CT arterial phase, whereas they were detectable in 28.5% of cases also during the venous phase (
p
= 0.02). All 13 cases of active bleeding were detected on the CT venous phase, and 76.9% of these cases were also revealed in the arterial phase, thus confirming their arterial origin (
p
= 0.22).
Conclusion
The addiction of the arterial phase to the venous phase in the CT assessment of patients who underwent high-energy blunt trauma allows an accurate identification and characterization of traumatic vascular injuries, so distinguishing between patients suitable for conservative management and those requiring interventional or surgical treatment.</description><identifier>ISSN: 1070-3004</identifier><identifier>EISSN: 1438-1435</identifier><identifier>DOI: 10.1007/s10140-019-01714-y</identifier><identifier>PMID: 31444680</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Bleeding ; Cases (containers) ; Computed Tomography Angiography ; Contrast Media ; Emergency Medicine ; Female ; Humans ; Imaging ; Injuries ; Injury analysis ; Iopamidol - analogs & derivatives ; Liver ; Liver - blood supply ; Liver - diagnostic imaging ; Liver - injuries ; Male ; Medicine ; Medicine & Public Health ; Original Article ; Radiology ; Retrospective Studies ; Tomography, X-Ray Computed ; Trauma ; Trauma Centers ; Vascular System Injuries - diagnostic imaging ; Wounds, Nonpenetrating - diagnostic imaging</subject><ispartof>Emergency radiology, 2019-12, Vol.26 (6), p.647-654</ispartof><rights>American Society of Emergency Radiology 2019</rights><rights>Emergency Radiology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-ad73583fdfef5c568fbf86ada577f5dbb0f89feaaec9c7cc27191c5c35a7888b3</citedby><cites>FETCH-LOGICAL-c441t-ad73583fdfef5c568fbf86ada577f5dbb0f89feaaec9c7cc27191c5c35a7888b3</cites><orcidid>0000-0003-4604-7384</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31444680$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iacobellis, Francesca</creatorcontrib><creatorcontrib>Scaglione, Mariano</creatorcontrib><creatorcontrib>Brillantino, Antonio</creatorcontrib><creatorcontrib>Scuderi, Maria Giuseppina</creatorcontrib><creatorcontrib>Giurazza, Francesco</creatorcontrib><creatorcontrib>Grassi, Roberto</creatorcontrib><creatorcontrib>Noschese, Giuseppe</creatorcontrib><creatorcontrib>Niola, Raffaella</creatorcontrib><creatorcontrib>Al Zuhir, Naail Yarub Sulaiman</creatorcontrib><creatorcontrib>Romano, Luigia</creatorcontrib><title>The additional value of the arterial phase in the CT assessment of liver vascular injuries after high-energy blunt trauma</title><title>Emergency radiology</title><addtitle>Emerg Radiol</addtitle><addtitle>Emerg Radiol</addtitle><description>Purpose
In the literature, no consensus exists about which CT protocol is to be adopted in patients who underwent high-energy blunt trauma. The aim of the study is to evaluate the additional value of the arterial phase in the CT assessment of vascular injuries of the liver.
Methods
Admission CT examinations for patients with traumatic injury of the liver due to high-energy blunt trauma, performed between 2011 and 2017 in two major trauma centres, were retrospectively reviewed. Images were analysed for presence or absence of liver parenchymal injury, intrahepatic contained vascular injuries and active bleeding in the arterial and portal venous phase of the CT study.
Results
Two hundred twelve patients have been identified. Parenchymal injuries were detected as isolated in 90.6% of cases, whereas they were associated with vascular injuries in 9.4% of cases: contained vascular injuries in 3.3% and active bleeding in 6.1%. Out of all parenchymal injuries detected on the CT portal venous phase, 90.5% were also detectable in the arterial phases (
p
< 0.0001). All of the contained vascular injuries were visible in the CT arterial phase, whereas they were detectable in 28.5% of cases also during the venous phase (
p
= 0.02). All 13 cases of active bleeding were detected on the CT venous phase, and 76.9% of these cases were also revealed in the arterial phase, thus confirming their arterial origin (
p
= 0.22).
Conclusion
The addiction of the arterial phase to the venous phase in the CT assessment of patients who underwent high-energy blunt trauma allows an accurate identification and characterization of traumatic vascular injuries, so distinguishing between patients suitable for conservative management and those requiring interventional or surgical treatment.</description><subject>Adult</subject><subject>Bleeding</subject><subject>Cases (containers)</subject><subject>Computed Tomography Angiography</subject><subject>Contrast Media</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Injuries</subject><subject>Injury analysis</subject><subject>Iopamidol - analogs & derivatives</subject><subject>Liver</subject><subject>Liver - blood supply</subject><subject>Liver - diagnostic imaging</subject><subject>Liver - injuries</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Tomography, X-Ray Computed</subject><subject>Trauma</subject><subject>Trauma Centers</subject><subject>Vascular System Injuries - diagnostic imaging</subject><subject>Wounds, Nonpenetrating - diagnostic imaging</subject><issn>1070-3004</issn><issn>1438-1435</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kUuLFDEUhYMozss_4EICbmZTmmcltZRGR2HATc863ErddFdTjzapDNS_n_T0qODCRZLLyXdOIIeQ95x94oyZz4kzrljFeFOW4apaX5FLrqStyqZfl5kZVknG1AW5SunAGKub2r4lF5IrpWrLLsm63SOFruuXfp5goI8wZKRzoMtJjwvGvqjHPSSk_fSsbrYUUsKURpyWEzr0jxiLM_k8QCzYIcceE4VQ7HTf7_YVThh3K22HXCxLhDzCDXkTYEj47uW8Jg_fvm4336v7n3c_Nl_uK68UXyrojNRWhi5g0F7XNrTB1tCBNiborm1ZsE1AAPSNN94LwxvutZcajLW2ldfk9px7jPOvjGlxY588DgNMOOfkhORCGGl0U9CP_6CHOcfyLYUSxkohGqELJc6Uj3NKEYM7xn6EuDrO3KkYdy7GlWLcczFuLaYPL9G5HbH7Y_ndRAHkGUjlatph_Pv2f2KfAFSfm3Q</recordid><startdate>20191201</startdate><enddate>20191201</enddate><creator>Iacobellis, Francesca</creator><creator>Scaglione, Mariano</creator><creator>Brillantino, Antonio</creator><creator>Scuderi, Maria Giuseppina</creator><creator>Giurazza, Francesco</creator><creator>Grassi, Roberto</creator><creator>Noschese, Giuseppe</creator><creator>Niola, Raffaella</creator><creator>Al Zuhir, Naail Yarub Sulaiman</creator><creator>Romano, Luigia</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4604-7384</orcidid></search><sort><creationdate>20191201</creationdate><title>The additional value of the arterial phase in the CT assessment of liver vascular injuries after high-energy blunt trauma</title><author>Iacobellis, Francesca ; Scaglione, Mariano ; Brillantino, Antonio ; Scuderi, Maria Giuseppina ; Giurazza, Francesco ; Grassi, Roberto ; Noschese, Giuseppe ; Niola, Raffaella ; Al Zuhir, Naail Yarub Sulaiman ; Romano, Luigia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-ad73583fdfef5c568fbf86ada577f5dbb0f89feaaec9c7cc27191c5c35a7888b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Bleeding</topic><topic>Cases (containers)</topic><topic>Computed Tomography Angiography</topic><topic>Contrast Media</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Humans</topic><topic>Imaging</topic><topic>Injuries</topic><topic>Injury analysis</topic><topic>Iopamidol - analogs & derivatives</topic><topic>Liver</topic><topic>Liver - blood supply</topic><topic>Liver - diagnostic imaging</topic><topic>Liver - injuries</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Tomography, X-Ray Computed</topic><topic>Trauma</topic><topic>Trauma Centers</topic><topic>Vascular System Injuries - diagnostic imaging</topic><topic>Wounds, Nonpenetrating - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iacobellis, Francesca</creatorcontrib><creatorcontrib>Scaglione, Mariano</creatorcontrib><creatorcontrib>Brillantino, Antonio</creatorcontrib><creatorcontrib>Scuderi, Maria Giuseppina</creatorcontrib><creatorcontrib>Giurazza, Francesco</creatorcontrib><creatorcontrib>Grassi, Roberto</creatorcontrib><creatorcontrib>Noschese, Giuseppe</creatorcontrib><creatorcontrib>Niola, Raffaella</creatorcontrib><creatorcontrib>Al Zuhir, Naail Yarub Sulaiman</creatorcontrib><creatorcontrib>Romano, Luigia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Source</collection><collection>ProQuest - 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Academic</collection><jtitle>Emergency radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iacobellis, Francesca</au><au>Scaglione, Mariano</au><au>Brillantino, Antonio</au><au>Scuderi, Maria Giuseppina</au><au>Giurazza, Francesco</au><au>Grassi, Roberto</au><au>Noschese, Giuseppe</au><au>Niola, Raffaella</au><au>Al Zuhir, Naail Yarub Sulaiman</au><au>Romano, Luigia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The additional value of the arterial phase in the CT assessment of liver vascular injuries after high-energy blunt trauma</atitle><jtitle>Emergency radiology</jtitle><stitle>Emerg Radiol</stitle><addtitle>Emerg Radiol</addtitle><date>2019-12-01</date><risdate>2019</risdate><volume>26</volume><issue>6</issue><spage>647</spage><epage>654</epage><pages>647-654</pages><issn>1070-3004</issn><eissn>1438-1435</eissn><abstract>Purpose
In the literature, no consensus exists about which CT protocol is to be adopted in patients who underwent high-energy blunt trauma. The aim of the study is to evaluate the additional value of the arterial phase in the CT assessment of vascular injuries of the liver.
Methods
Admission CT examinations for patients with traumatic injury of the liver due to high-energy blunt trauma, performed between 2011 and 2017 in two major trauma centres, were retrospectively reviewed. Images were analysed for presence or absence of liver parenchymal injury, intrahepatic contained vascular injuries and active bleeding in the arterial and portal venous phase of the CT study.
Results
Two hundred twelve patients have been identified. Parenchymal injuries were detected as isolated in 90.6% of cases, whereas they were associated with vascular injuries in 9.4% of cases: contained vascular injuries in 3.3% and active bleeding in 6.1%. Out of all parenchymal injuries detected on the CT portal venous phase, 90.5% were also detectable in the arterial phases (
p
< 0.0001). All of the contained vascular injuries were visible in the CT arterial phase, whereas they were detectable in 28.5% of cases also during the venous phase (
p
= 0.02). All 13 cases of active bleeding were detected on the CT venous phase, and 76.9% of these cases were also revealed in the arterial phase, thus confirming their arterial origin (
p
= 0.22).
Conclusion
The addiction of the arterial phase to the venous phase in the CT assessment of patients who underwent high-energy blunt trauma allows an accurate identification and characterization of traumatic vascular injuries, so distinguishing between patients suitable for conservative management and those requiring interventional or surgical treatment.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>31444680</pmid><doi>10.1007/s10140-019-01714-y</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4604-7384</orcidid></addata></record> |
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| ispartof | Emergency radiology, 2019-12, Vol.26 (6), p.647-654 |
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| language | eng |
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| source | Springer Nature |
| subjects | Adult Bleeding Cases (containers) Computed Tomography Angiography Contrast Media Emergency Medicine Female Humans Imaging Injuries Injury analysis Iopamidol - analogs & derivatives Liver Liver - blood supply Liver - diagnostic imaging Liver - injuries Male Medicine Medicine & Public Health Original Article Radiology Retrospective Studies Tomography, X-Ray Computed Trauma Trauma Centers Vascular System Injuries - diagnostic imaging Wounds, Nonpenetrating - diagnostic imaging |
| title | The additional value of the arterial phase in the CT assessment of liver vascular injuries after high-energy blunt trauma |
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