Τίτλος:
MDCTA volumetric analysis for the quantification and grading of acute
non-cerebral, non-gastrointestinal hemorrhage: a feasibility study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose To assess the feasibility of multi-detector computed tomography
angiography (MDCTA) volumetry for the quantification and grading of
acute non-cerebral, non-gastrointestinal bleeding. Methods This
retrospective, single-center study investigated consecutive patients
with MDCTA positive for active non-cerebral, non-gastrointestinal
bleeding, between January 2020 and June 2020. Outcome measures were the
quantification of active extravasation at the arterial and parenchymal
phase using volumetry measurements, the calculation of active bleeding
rate and bleeding grading, 30-day mortality rate, identification of
independent predictors of mortality and correlation between volumetric
analysis, various clinical features, and the decision to proceed with an
intervention. Results In total 30 patients (17 females; 56.6%; mean age
70.0 +/- 16.0 years) were analyzed. Volumetric analysis was feasible in
all cases resulting in excellent inter-observer variability (interclass
correlation coefficient 0.999 for arterial and 0.919 for venous volume
measurements). Mean volume of contrast extravasation was 1.06 +/- 1.09
ml and 3.07 +/- 2.48 ml at the arterial and parenchymal phases,
respectively. Mean bleeding rate was 6.95 +/- 7.82 ml/min. High bleeding
volume at arterial phase (grade 4 bleeding) was the only independent
predictor of 30-day mortality (HR 1383.58; p = 0.042). There was a
positive correlation between bleeding volume at arterial phase (r(s) =
0.340; p = 0.033) and arterial bleeding rate (r(s) = 0.381; p = 0.019)
with the decision to proceed with an intervention. Bleeding volume of
0.6 ml was the cutoff value for the prediction of intervention
(sensitivity 96.3%; specificity 66.7%). Conclusions MDCTA volumetric
analysis for the quantification and grading of acute hemorrhage was
feasible with excellent inter-observer agreement. The proposed bleeding
grading system could optimize decision making and predict clinical
outcomes.
Συγγραφείς:
Spiliopoulos, Stavros
Theodosis, Antonios
Palialexis,
Konstantinos
Efthimiou, Evgenia
Reppas, Lazaros
Argentos,
Stylianos
Filippiadis, Dimitrios
Kelekis, Nikolaos and
Brountzos, Elias
Περιοδικό:
Emergency Radiology
Εκδότης:
Springer Berlin Heidelberg
Λέξεις-κλειδιά:
Computed tomography angiography; Hemorrhage; Endovascular procedures;
Volumetry
DOI:
10.1007/s10140-021-01975-6
