Itani K M, Rothenberg S S, Brandt M L, Burch J M, Mattox K L, Harberg F J, Pokorny W J
Cora and Webb Madding Department of Surgery, Baylor College of Medicine, Houston, TX.
J Pediatr Surg. 1993 May;28(5):677-80. doi: 10.1016/0022-3468(93)90030-o.
During the 6-year period from 1983 to 1989, 109 children aged 3 to 18 years (mean, 16) with suspected peripheral vascular injuries underwent 113 emergency center arteriograms (ECA) performed by hand injection of contrast material using a single roentgenographic film. The most common indication for ECA was the proximity of the injury in 93 (82.3%) of the cases as penetrating injury accounted for 106 (94%) of the cases. There were 89 true-negative, 14 true-positive, 1 false-negative, and no false-positive arteriograms. The remaining 9 arteriograms were either equivocal or technically inadequate. The sensitivity, specificity, and diagnostic accuracy of this procedure were 98.9%, 100%, and 91.2%, respectively. Operative intervention was required for 9 (64.2%) injuries detected by emergency arteriography. The remaining 5 injuries were considered minor and were observed with no complications during a period of 21 months. Sixty-eight children (76.4%) with negative ECA were followed for a mean of 12 months with no vascular complications or growth abnormalities noted. ECA is a rapid, accurate, and cost-effective technique. It is of particular value in detecting the presence of occult arterial injuries that might have deleterious effects in the growing child.
在1983年至1989年的6年期间，109名年龄在3至18岁（平均16岁）疑似周围血管损伤的儿童接受了113次急诊中心动脉造影（ECA），通过手动注射造影剂并使用单张X线片进行。ECA最常见的指征是93例（82.3%）损伤部位临近，因为106例（94%）为穿透伤。动脉造影结果为89例假阴性、14例假阳性、1例假阴性，无真阳性。其余9次动脉造影结果不明确或技术上不充分。该检查方法的敏感性、特异性和诊断准确性分别为98.9%、100%和91.2%。急诊动脉造影检测出的9例（64.2%）损伤需要手术干预。其余5例损伤被认为较轻，在21个月的观察期内无并发症。68例（76.4%）ECA结果为阴性的儿童平均随访12个月，未发现血管并发症或生长异常。ECA是一种快速、准确且具有成本效益的技术。它在检测可能对生长中的儿童产生有害影响的隐匿性动脉损伤方面具有特别价值。
