Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis
<i>Background and objective</i>: The early detection of underlying hemorrhage of pelvic trauma has been a critical issue. The aim of this study was to systematically determine the diagnostic accuracy of computed tomography (CT) for detecting severe pelvic hemorrhage. <i>Materials a...
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doaj-bcc120cb2de5450eb27c19fa9ab4ded32021-01-13T00:02:24ZengMDPI AGMedicina1010-660X2021-01-0157636310.3390/medicina57010063Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-AnalysisSung Nam Moon0Jung-Soo Pyo1Wu Seong Kang2Department of Radiology, Wonkwang University Hospital, Iksan 54538, KoreaDepartment of Pathology, Eulji University School of Medicine, Uijeongbu Eulji University, Kyeonggi-do 11759, KoreaDepartment of Trauma Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan 54538, Korea<i>Background and objective</i>: The early detection of underlying hemorrhage of pelvic trauma has been a critical issue. The aim of this study was to systematically determine the diagnostic accuracy of computed tomography (CT) for detecting severe pelvic hemorrhage. <i>Materials and Methods</i>: Relevant articles were obtained by searching PubMed, EMBASE, and Cochrane databases through 28 November 2020. Diagnostic test accuracy results were reviewed to obtain the sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic curve of CT for the diagnosis in pelvic trauma patients. The positive finding on CT was defined as the contrast extravasation. As the reference standard, severe pelvic hemorrhage was defined as an identification of bleeding at angiography or by direct inspection using laparotomy that required hemostasis by angioembolization or surgery. A subgroup analysis was performed according to the CT modality that is divided by the number of detector rows. <i>Result</i>: Thirteen eligible studies (29 subsets) were included in the present meta-analysis. Pooled sensitivity of CT was 0.786 [95% confidence interval (CI), 0.574–0.909], and pooled specificity was 0.944 (95% CI, 0.900–0.970). Pooled sensitivity of the 1–4 detector row group and 16–64 detector row group was 0.487 (95% CI, 0.215–0.767) and 0.915 (95% CI, 0.848–0.953), respectively. Pooled specificity of the 1–4 and 16–64 detector row groups was 0.956 (95% CI, 0.876–0.985) and 0.906 (95% CI, 0.828–0.951), respectively. <i>Conclusion</i>: Multi-detector CT with 16 or more detector rows has acceptable high sensitivity and specificity. Extravasation on CT indicates severe hemorrhage in patients with pelvic trauma.https://www.mdpi.com/1010-660X/57/1/63traumacomputed tomographyhemorrhageangiographypelvis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sung Nam Moon Jung-Soo Pyo Wu Seong Kang |
spellingShingle |
Sung Nam Moon Jung-Soo Pyo Wu Seong Kang Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis Medicina trauma computed tomography hemorrhage angiography pelvis |
author_facet |
Sung Nam Moon Jung-Soo Pyo Wu Seong Kang |
author_sort |
Sung Nam Moon |
title |
Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis |
title_short |
Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis |
title_full |
Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis |
title_fullStr |
Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis |
title_full_unstemmed |
Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis |
title_sort |
accuracy of contrast extravasation on computed tomography for diagnosing severe pelvic hemorrhage in pelvic trauma patients: a meta-analysis |
publisher |
MDPI AG |
series |
Medicina |
issn |
1010-660X |
publishDate |
2021-01-01 |
description |
<i>Background and objective</i>: The early detection of underlying hemorrhage of pelvic trauma has been a critical issue. The aim of this study was to systematically determine the diagnostic accuracy of computed tomography (CT) for detecting severe pelvic hemorrhage. <i>Materials and Methods</i>: Relevant articles were obtained by searching PubMed, EMBASE, and Cochrane databases through 28 November 2020. Diagnostic test accuracy results were reviewed to obtain the sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic curve of CT for the diagnosis in pelvic trauma patients. The positive finding on CT was defined as the contrast extravasation. As the reference standard, severe pelvic hemorrhage was defined as an identification of bleeding at angiography or by direct inspection using laparotomy that required hemostasis by angioembolization or surgery. A subgroup analysis was performed according to the CT modality that is divided by the number of detector rows. <i>Result</i>: Thirteen eligible studies (29 subsets) were included in the present meta-analysis. Pooled sensitivity of CT was 0.786 [95% confidence interval (CI), 0.574–0.909], and pooled specificity was 0.944 (95% CI, 0.900–0.970). Pooled sensitivity of the 1–4 detector row group and 16–64 detector row group was 0.487 (95% CI, 0.215–0.767) and 0.915 (95% CI, 0.848–0.953), respectively. Pooled specificity of the 1–4 and 16–64 detector row groups was 0.956 (95% CI, 0.876–0.985) and 0.906 (95% CI, 0.828–0.951), respectively. <i>Conclusion</i>: Multi-detector CT with 16 or more detector rows has acceptable high sensitivity and specificity. Extravasation on CT indicates severe hemorrhage in patients with pelvic trauma. |
topic |
trauma computed tomography hemorrhage angiography pelvis |
url |
https://www.mdpi.com/1010-660X/57/1/63 |
work_keys_str_mv |
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