Niwa T, Takebayashi S, Igari H, Morimura N, Uchida K, Sugiyama M, Matsubara S
Department of Radiology, Yokohama City University Medical Center, Japan.
Br J Radiol. 2000 Sep;73(873):945-50. doi: 10.1259/bjr.73.873.11064646.
40 haemodynamically unstable patients with pelvic injuries were studied to assess the ability of plain radiographs to detect haemorrhagic sites. Pelvic radiographs and bilateral angiograms were reviewed separately for detection of haemorrhagic sites in both anterior and posterior segments. Sensitivity and specificity of pelvic radiographs for the detection of haemorrhagic sites were obtained by analysis of angiographic findings. Angiography demonstrated arterial injury in 106 divisions: 26 right anterior, 22 right posterior, 33 left anterior and 25 left posterior. Sensitivities of the radiographs for predicting haemorrhagic sites were higher in the anterior segment (right, 96%; left, 100%) than in the posterior segment (right, 73%; left, 83%). However, specificities were lower in the anterior segment (right, 79%; left, 78%) than in the posterior segment (right, 100%; left, 100%). In 15 (58%) of 26 patients with in-dwelling Foley catheters, including those with catheter deviation, the severity of anterior injury indicated on plain radiographs was correlated with angiographic findings. Plain radiographs of the pelvis proved useful for predicting haemorrhagic sites in haemodynamically unstable patients with pelvic fractures, especially in those with anterior fractures.
对40例血流动力学不稳定的骨盆损伤患者进行研究，以评估X线平片检测出血部位的能力。分别回顾骨盆X线片和双侧血管造影，以检测前后段的出血部位。通过分析血管造影结果，得出骨盆X线片检测出血部位的敏感性和特异性。血管造影显示106处动脉损伤：右侧前支26处、右侧后支22处、左侧前支33处、左侧后支25处。X线片预测出血部位的敏感性在前段（右侧，96%；左侧，100%）高于后段（右侧，73%；左侧，83%）。然而，特异性在前段（右侧，79%；左侧，78%）低于后段（右侧，100%；左侧，100%）。在26例留置Foley导尿管的患者中，有15例（58%），包括导尿管移位的患者，X线平片显示的前侧损伤严重程度与血管造影结果相关。骨盆X线平片被证明有助于预测血流动力学不稳定的骨盆骨折患者的出血部位，尤其是前侧骨折患者。
