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タイトル: | Association between contrast extravasation on computed tomography scans and pseudoaneurysm formation in pediatric blunt splenic and hepatic injury: A multi-institutional observational study |
著者: | Katsura, Morihiro Fukuma, Shingo https://orcid.org/0000-0002-8379-8761 (unconfirmed) Kuriyama, Akira Takada, Tadaaki Ueda, Yasuhiro Asano, Shima Kondo, Yutaka Ie, Masafumi Matsushima, Kazuhide Murakami, Takahiro Fukuzato, Yoshimitsu Osaki, Nobuhiro Mototake, Hidemitsu Fukuhara, Shunichi |
著者名の別形: | 桂, 守弘 福間, 真悟 福原, 俊一 |
キーワード: | Pediatric trauma Spleen and liver injury Contrast extravasation CT blush Pseudoaneurysm |
発行日: | Apr-2020 |
出版者: | Elsevier BV |
誌名: | Journal of pediatric surgery |
巻: | 55 |
号: | 4 |
開始ページ: | 681 |
終了ページ: | 687 |
抄録: | PURPOSE: We aimed to examine the association between contrast extravasation (CE) on initial computed tomography (CT) scan and pseudoaneurysm (PSA) development in pediatric blunt splenic and/or liver injury. METHODS: We conducted a multi-institutional retrospective study in cases of blunt splenic and/or hepatic injury who underwent an initial attempt of nonoperative management. A logistic regression model was used to compare PSA formation and CE on initial CT scan, and the area under the receiver operating characteristic curve (AUC) with and without CE was used to assess the predictive performance of CE for PSA formation. RESULTS: Of 236 cases enrolled from 10 institutions, PSA formation was observed in 17 (7.2%). Multivariate analysis showed a significant association between CE on initial CT scan and increased incidence of PSA formation (odds ratio, 4.96; 95% confidence interval, 1.37-18.0). There was no statistically significant association between the grade of injury and PSA formation. The AUC improved from 0.75 (0.64-0.87) to 0.80 (0.70-0.91) with CE. CONCLUSION: Active CE on initial CT scan was an independent predictor of PSA formation. Selective use of follow-up CT in children who showed CE on initial CT may provide early identification of PSA formation, regardless of injury grade. LEVEL OF EVIDENCE: Prognostic and epidemiological, level III. |
著作権等: | © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ The full-text file will be made open to the public on 01 April 2021 in accordance with publisher's 'Terms and Conditions for Self-Archiving'. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。 This is not the published version. Please cite only the published version. |
URI: | http://hdl.handle.net/2433/251015 |
DOI(出版社版): | 10.1016/j.jpedsurg.2019.07.005 |
PubMed ID: | 31350043 |
出現コレクション: | 学術雑誌掲載論文等 |
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