计算机断层血管造影在儿童颈部和四肢血管创伤中的价值
Value of computed tomographic angiography in neck and extremity pediatric vascular trauma.
作者信息
Hogan Anthony R, Lineen Edward B, Perez Eduardo A, Neville Holly L, Thompson William R, Sola Juan E
机构信息
DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery and Division of Trauma/Critical Care, University of Miami Miller School of Medicine, Miami, Fla 33136, USA.
出版信息
J Pediatr Surg. 2009 Jun;44(6):1236-41; discussion 1241. doi: 10.1016/j.jpedsurg.2009.02.039.
PURPOSE
We sought to define the sensitivity and specificity of computed tomographic angiography (CTA) in pediatric vascular injuries.
METHODS
All neck and extremity CTAs performed in pediatric patients at a level 1 trauma center were reviewed from 2001 to 2007.
RESULTS
Overall, 78 patients were identified with an average age of 15.0 +/- 4.0 (0-18 years). Males outnumbered females 3.6:1. CTA was performed for 41 penetrating and 37 blunt traumas. Most penetrating injuries were due to missile wounds (71%) or stab wounds (17%). Eleven major vascular injuries resulted from penetrating trauma. For penetrating trauma, CTA was 100% sensitive and 93% specific. CTA for penetrating trauma had a positive predictive value (PPV) of 85% and negative predictive value (NPV) of 100%. Most blunt injuries were due to motor vehicle accidents (57%), followed by pedestrian hit by car (27%). Eight major vascular injuries resulted from blunt trauma. For blunt trauma, CTA was 88% sensitive and 100% specific. CTA for blunt trauma had a PPV of 100% and an NPV of 97%. The accuracy for penetrating and blunt trauma was 95% and 97%, respectively.
CONCLUSIONS
CTA is highly sensitive, specific, and accurate for pediatric neck and extremity vascular trauma.
目的
我们试图确定计算机断层血管造影（CTA）在小儿血管损伤中的敏感性和特异性。
方法
回顾了2001年至2007年在一级创伤中心对小儿患者进行的所有颈部和四肢CTA检查。
结果
总共确定了78例患者，平均年龄为15.0±4.0岁（0至18岁）。男性与女性的比例为3.6：1。进行CTA检查的有41例穿透伤和37例钝性伤。大多数穿透伤是由枪伤（71%）或刺伤（17%）所致。11例主要血管损伤由穿透伤引起。对于穿透伤，CTA的敏感性为100%，特异性为93%。穿透伤CTA的阳性预测值（PPV）为85%，阴性预测值（NPV）为100%。大多数钝性伤是由机动车事故（57%）引起的，其次是行人被汽车撞击（27%）。8例主要血管损伤由钝性伤引起。对于钝性伤，CTA的敏感性为88%，特异性为100%。钝性伤CTA的PPV为100%，NPV为97%。穿透伤和钝性伤的准确率分别为95%和97%。
结论
CTA对小儿颈部和四肢血管创伤具有高度敏感性、特异性和准确性。
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