Learning objectives
Review CT findings of solid visceral and vascular trauma (active contrast extravasation,
pseudoaneurysm formation,
vessel dissection and traumatic AV fistulas).
Review angiography,
transarterial embolization and stent graft placement with sample cases.
Background
Trauma remains a leading cause of mortality worldwide andleading cause of death in people below age 44 in the US[22].
Interventional radiologist'straining in transcatheter therapies and multimodality imaging have rendered these physicians indispensable to trauma teams.
Digital subtraction angiography (DSA),
transarterial embolization (TAE),
stenting and other interventional methods have changed management of trauma patients,
providing minimally invasive procedures with high success rates and low patient morbidity.
Though surgery had beengold standard for hemorrhage control,TAE has emerged as an effective,
safe option to treat solid organ...
Findings and procedure details
CT FINDINGS:
Active Contrast Extravasation
Better identified on dual-phase CT,
refers to a focal area or jet of increased attenuation within a hematoma.
The hyperattenuating area must change/enlarge on delayed images Fig. 1,
in keeping with an active bleeding[9].
Bone fragments or foreign bodies also appear as areas of high attenuation,
but don't change configuration on delayed imaging[9].
Pseudoaneurysm Formation
Refer to injuryinvolving the media and intima vessel wall layers,
resulting in the tunica adventitia retainingblood and forming a vessel outpouching.
They have high rupture...
Conclusion
Interventional radiologists play a crucial role in the evaluation and treatment of trauma patients. Practicing minimally invasive techniques,
IRs are able to sucessfully treat life threatening hemorrhage,
while reducing morbidity.
References
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Transcatheter Arterial Embolization in the Trauma Patient: A Review.
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