Application of Enhanced CT in Assessing the Source of Active Haemorrhage in Patients with Abdominal and Pelvic Trauma

Objective: To assess the ability of contrast enhanced computed tomography(CECT) to detect active haemorrhage in abdominal and pelvic trauma patients, using angiographic findings as paired gold standards.Methods: A retrospective analysis of patients with abdominal and pelvic trauma from January 2016 to February2019, all patients underwent abdominal-pelvic enhanced CT after admission, and DSA angiography or embolization within 24 hours of injury, all CT and DSA images were judged by two relevant professional physicians(one of whom is the deputy chief physician).we obtain sensitivity, specificity, positive predictive value, negative predictive value of CT detect hemorrhage by compared with DSA images(as gold standard).Results: During the periods, 33 adult trauma patients sustaining enhanced CT scan of abdominal and pelvic followed by angiography.Ten patients were negative for extravasations from either of the tests.Twenty of 33 patients had both positive CT scans and angiograms.Only one patient with positive CT scans did not have bleeding on angiogram.Two with positive angiograms did not show any extravasations of contrast on CT scan.The sensitivity(SE), specificity(SP), positive predictive value(PPV) and negative predictive value(NPV) of CECT in detecting active abdominopelvic haemorrhage, as compared to DSA, were 90.9%, 90.9%, 95.2% and 83.3%, respectively.Conclusions: Contrast enhanced CT shows high sensitivity and positive predictive value for the detection of active haemorrhage in patients with blunt abdominopelvic trauma, when compared with DSA, and can be used to triage patients for management.