Relative Threshold of Detection of Active Arterial Bleeding: In Vitro Comparison of MDCT and Digital Subtraction Angiography

• DOI: 10.2214/ajr.07.2290
• Publication Date: 2007-10-22T17:00:12Z
• Authors: Shuvro H. Roy-Cho...; David J. Gallacher; John Pilmer; Sheila Rankin; Geoff Fowler; Jeff Steers; Renato Dourado; Paul Woodburn; Andreas Adam
• Keywords: Pulsatile flow; Digital subtraction angiography; Bolus (digestion)

The objective of our study was to determine the relative sensitivity and lowest threshold bleeding detectable with digital subtraction angiography (DSA) MDCT using an in vitro physiologic system.A closed pulsatile cardiopulmonary bypass circuit connected tubes traversing a water bath simulate abdominal aorta inferior vena cava. Three smaller interconnecting acrylic plastic were as branches aortic tubing branch vessels. One three tubes, control, had no holes it, one 100-microm hole, 280-microm hole. leakage rates predetermined cardiac output 2 4 L/min mean arterial pressure (MAP) ranging from 30 100 mm Hg for each hole size. following studies performed rates. For 1, 16-MDCT bolus tracking after 35 mL contrast medium been injected into simulated peripheral vein. 2, DSA 4-French straight catheter placed 10 cm proximal (selective first cannulation). 3, small at site (highly superselective). 4, holes, detection lower Cine loops images examined by two blinded observers detect extravasation (i.e., arteries). Interobserver agreement studied Cohen's kappa statistic.The follows study: IV contrast-enhanced (study 1), it 0.35 mL/min; 2), 0.96 3), 0.05 mL/min [corrected] or lower; intraarterial selective 4), lower. ease improved increasing MAPs larger volumes leakage. correlation excellent.In vitro, i.v. is more sensitive than first-order branch-selective detecting active hemorrhage unless position highly superselective close artery. These results suggest that can be used initial imaging technique diagnosis if clinical condition patient allows.