突发性脑血管损伤:我们是否过度选低机制创伤?
Kevin D Hiatt1,2, Raghav Agarwal3, Chesney S Oravec3,4
1From the Wake Forest School of Medicine (K.S.H., R.A., C.S.O., N.P.P., C.P.G., S.Q.W., M.E.Z.). Winston-Salem, North Carolina kehiatt@wakehealth.edu.
AJNR. American journal of neuroradiology
|October 12, 2023
概括
使用部CTA对低机制创伤患者进行查,以寻找的脑血管损伤,通常是不必要的. 排除不符合扩展的丹佛标准的患者可以防止错误阳性,而不会缺失伤害.
科学领域:
- 创伤外科 手术 创伤外科
- 血管外科 血管外科
- 紧急医疗 紧急医疗
- 放射学 放射学是一门学科.
背景情况:
- 在创伤患者中,粗脑血管损伤 (BCVI) 查是常见的,但有争议.
- 关于适当的查标准存在分歧,特别是在低机制创伤方面.
研究的目的:
- 评估是否有必要对低机制创伤患者进行BCVI查.
- 为了确定当前的查实践是否在这个患者子组中是合理的.
主要方法:
- 在一级创伤中心进行部CTA的成年创伤患者的回顾性审查.
- 对临床和成像风险因素,创伤机制,CTA解释和结果的分析.
- 包括随后的CTA/DSA发现和治疗数据.
主要成果:
- 在1136个部CTA中,4%为BCVI阳性.
- 在不符合扩展的丹佛标准的低机制创伤病例中,查可以避免0次错过的缺血性中风和12次错误阳性病例.
- 在12.6%的病例中发现了BCVI,1.7%的病例不符合扩展的丹佛标准.
结论:
- 在低机制创伤中进行BCVI查应保留给符合扩展的丹佛标准的患者.
- 需要进一步的研究来澄清不确定的发现,并区分真假阳性.
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