Keywords:
Trauma, Embolisation, CT-Angiography, Catheter arteriography, Interventional vascular, Pelvis
Authors:
G. Harisis, J. Lee, W. Clements, G. S. Goh; Melbourne/AU
DOI:
10.1594/ranzcr2018/R-0036
Methods and materials
This retrospective study was conducted at a level 1 tertiary trauma centre in Melbourne,
Australia with institutional ethics approval. Patients over a 6 year period who underwent a single phase trauma portal venous CT abdomen and pelvis (first 3 year period) or dual-bolus CT abdomen and pelvis (second 3 year period) and were diagnosed with active bleeding were included (See Figure 1 for details of the dual bolus protocol).
Of these patients,
only those that subsequently proceeded to digital subtraction angiography (DSA) were included for analysis with DSA considered the gold standard for confirming the presence of active arterial bleeding or injury5.
All CT scans were retrospectively reviewed by two independent consultant interventional radiologists who recorded the presence or absence of active bleeding.
If bleeding was present,
the radiologists recorded whether this was likely arterial,
venous or unable to distinguish.
Reviewers were blinded to the results of subsequent DSA and to each other’s findings.
Results were compared to the findings of subsequent DSA,
which allowed for the calculation of radiologist diagnostic sensitivity/specificity and inter-observer agreement as measured by unweighted Cohen’s Kappa coefficient.