Evidence map›Paper›PMID 41037156›Full record

ArticleEmergency radiology2025

Split-bolus single-pass CT in splenic injury: does it miss relevant vascular injury? : Article type: original research.

Sadia R Qamar, Ferco H Berger, Tjarda N Tromp, Digna R Kool, Ludo F M Beenen, Bernd P Teunissen, Maeke J Scheerder, Michael J R Edwards, Monique Brink

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Article in Emergency radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sadia R Qamar *Emergency and Trauma Radiology Division, Department of Medical Imaging, Precision Diagnostics and Therapeutics Program, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Ontario, M4N 3M5, Toronto, Canada.ORCID http://orcid.org/0000-0001-6637-6092
Ferco H Berger *Emergency and Trauma Radiology Division, Department of Medical Imaging, Precision Diagnostics and Therapeutics Program, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Ontario, M4N 3M5, Toronto, Canada. ferco.berger@sunnybrook.ca.ORCID http://orcid.org/0000-0003-3696-2554
Tjarda N TrompDepartment of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0003-2037-8388
Digna R KoolDepartments of Radiology and Nuclear Medicine, Amsterdam UMC University of Amsterdam, Amsterdam, The Netherlands.ORCID http://orcid.org/0009-0009-5496-8803
Ludo F M BeenenDepartments of Radiology and Nuclear Medicine, Amsterdam UMC University of Amsterdam, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0001-9204-1026
Bernd P TeunissenDepartments of Radiology and Nuclear Medicine, Amsterdam UMC Free University, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-1122-155X
Maeke J ScheerderDepartments of Radiology and Nuclear Medicine, Amsterdam UMC University of Amsterdam, Amsterdam, The Netherlands.ORCID http://orcid.org/0009-0007-4718-7879
Michael J R EdwardsDepartment of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0001-8035-8157
Monique BrinkDepartment of Medical Imaging, Radboud University Medical Center, Geert Grooteplein 10, Nijmegen, 6525GA, The Netherlands.ORCID http://orcid.org/0000-0002-4146-1052

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate diagnostic performance of split-bolus single-pass CT (SBSP-CT) for splenic vascular injury (SVI) and clinically relevant splenic vascular injury requiring treatment (CR-SVI) in trauma patients with splenic injury.

methodsThis retrospective observer study included 111 consecutive trauma patients (76% male), mean age 37 years (9-81), median ISS 27 (interquartile range (IQR) 26-33), with splenic injury and primary SBSP-CT at a level-1 trauma center between December 2012 and December 2018. Four radiologists independently scored CTs for SVI presence and likelihood. Consensus reference standards for SVI and CR-SVI were based on clinical, imaging and 3-month follow-up data. Image adequacy was assessed quantitively and qualitatively and diagnostic performance and interobserver agreement analyzed.

results37 of 111 (33.3%) patients had SVI and 27 (24.3%) had CR-SVI requiring treatment. Five patients died prior to SVI treatment from unrelated injuries; no mortality was attributed to undetected SVI. Two patients had delayed splenic rupture, both survived. Median attenuation was 292 HU (IQR 250-348) in the aorta and 130 HU (IQR 114-150) in splenic parenchyma. Images were adequate in 107 of 111 (96.4%) patients. Interobserver agreement for SVI was substantial (0.741; 95% CI: 0.67-0.82). NPV for SVI ranged from 89.2 to 94.4% (95% CI: 89.2-97.4) and for CR-SVI from 94.4 to 97.1% (95% CI: 88.5-98.9). AUROC for SVI ranged from 0.825 to 0.862 and for CR-SVI from 0.825 to 0.862.

conclusionSBSP-CT provides adequate image quality and high diagnostic confidence for evaluating splenic vascular injury with high negative predictive value for relevant splenic vascular injuries.

Indexed as

SpleenTomography, X-Ray ComputedVascular System InjuriesAdolescentAdultAgedAged, 80 and overChildContrast MediaFemaleHumansMaleMiddle AgedRetrospective StudiesContrast MediaAbdominal traumaInterventional angiographySpleenSplenectomySplenic vascular injurySplit-bolus single-pass CT

Identifiers

PMID41037156

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.