Division of Pediatric Radiology, Department of Radiology, University of Colorado, Children's Hospital Colorado, 13123 East 16th Avenue, Aurora, CO, 80045, USA.
Department of Pediatric Radiology, Lucile Packard Children's Hospital, Stanford Medicine, Palo Alto, CA, USA.
Emerg Radiol. 2022 Oct;29(5):903-914. doi: 10.1007/s10140-022-02067-9. Epub 2022 Jun 9.
While interventional radiologists occupy a critical role in adult trauma management, the role of interventionalist in pediatric trauma continues to evolve. The indications for transarterial embolization (TAE) are significantly different in pediatric patients in whom non-operative management (NOM) has a much more prominent role than in adults. Contrast extravasation on imaging may not require acute surgical or interventional management as it would in an adult. There are also areas in which pediatric interventional radiology is increasingly useful such as pelvic TAE in failed management, or splenic embolization to treat bleeding without the loss of splenic function inherent to surgical splenectomy. The rapid evolution of techniques and devices in pediatric patients is also changing what interventions are possible in pediatric trauma management which necessitates frequent reassessment of the guidelines and interventional radiology's role in caring for these patients.
This review seeks to consolidate the recent literature to describe the evolving role of the interventional radiologist in pediatric trauma management.
虽然介入放射学家在成人创伤管理中扮演着关键角色,但介入医师在儿科创伤中的角色仍在不断发展。在儿科患者中,经动脉栓塞(TAE)的适应证与成人有很大的不同,非手术治疗(NOM)的作用更为突出。与成人相比,影像学上的造影剂外渗可能不需要立即进行手术或介入治疗。在某些领域,儿科介入放射学也越来越有用,例如在失败的治疗中进行骨盆 TAE,或进行脾栓塞以治疗出血,而不会像脾切除术那样失去脾脏功能。技术和设备在儿科患者中的快速发展也改变了儿科创伤管理中可能进行的干预措施,这需要频繁重新评估指南以及介入放射学在治疗这些患者中的作用。
本综述旨在整合近期文献,描述介入放射学家在儿科创伤管理中不断发展的角色。