Comparison of MDCT Protocols in Trauma Patients with Suspected Splenic Injury: Superior Results with Protocol That Includes Arterial and Portal Venous Phase Imaging

Overview

Journal Diagn Interv Radiol

Publisher Galenos Publishing House

Date 2016 Jun 24

PMID 27334296

Citations 6

Authors

Raymond Melikian

Stephanie Goldberg

Brian James Strife

Robert A Halvorsen

Affiliations

Soon will be listed here.

Abstract

Purpose: We aimed to determine which intravenous contrast-enhanced multidetector computed tomography (MDCT) protocol produced the most accurate results for the detection of splenic vascular injury in hemodynamically stable patients who had sustained blunt abdominal trauma.

Methods: We retrospectively reviewed 88 patients from 2003 to 2011 who sustained blunt splenic trauma and underwent contrast-enhanced MDCT and subsequent angiography. Results of MDCT scans utilizing single phase (portal venous only, n=8), dual phase (arterial + portal venous or portal venous + delayed, n=42), or triple phase (arterial + portal venous + delayed, n=38) were compared with results of subsequent splenic angiograms for the detection of splenic vascular injury.

Results: Dual phase imaging was more sensitive and accurate than single phase imaging (P = 0.016 and P = 0.029, respectively). When the subsets of dual phase imaging were compared, arterial + portal venous phase imaging was more sensitive and accurate than portal venous + delayed phase imaging (P = 0.005 and P = 0.002, respectively). Triple phase imaging was more accurate (P = 0.015) than dual phase; however, when compared with the dual phase subset of arterial + portal venous, there was no statistical difference in either sensitivity or accuracy.

Conclusion: Our results support the use of dual phase contrast-enhanced MDCT, which includes the arterial phase, in patients with suspected splenic injury and question the utility of obtaining a delayed sequence.

Citing Articles

Impact of early arterial-phase multidetector CT in blunt spleen injury: a clinical outcomes-oriented study.

Wang Y, Wu Y, Chen H, Tee Y, Fu C, Liao C BMC Med Imaging. 2025; 25(1):39.

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Blunt splenic injury: Assessment of follow-up CT utility using quantitative volumetry.

Dreizin D, Yu T, Motley K, Li G, Morrison J, Liang Y Front Radiol. 2022; 2.

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MDCTA volumetric analysis for the quantification and grading of acute non-cerebral, non-gastrointestinal hemorrhage: a feasibility study.

Spiliopoulos S, Theodosis A, Palialexis K, Efthimiou E, Reppas L, Argentos S Emerg Radiol. 2021; 28(6):1151-1159.

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Unidentified bright objects of spleen on arterial phase CT: mimicker of splenic vascular injury in blunt abdominal trauma.

Hemachandran N, Gamanagatti S, Sharma R, Kumar A, Gupta A, Kumar S Diagn Interv Radiol. 2021; 27(4):497-503.

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Revised AAST scale for splenic injury (2018): does addition of arterial phase on CT have an impact on the grade?.

Hemachandran N, Gamanagatti S, Sharma R, Shanmuganathan K, Kumar A, Gupta A Emerg Radiol. 2020; 28(1):47-54.

PMID: 32705369 DOI: 10.1007/s10140-020-01823-z.

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