Pelvic trauma: impact of iodinated contrast material extravasation at MDCT on patient management

article; PURPOSE: To determine the impact of iodinated contrast material extravasation at MDCT in selecting patients with pelvic fractures that require vascular embolization. PATIENTS AND METHODS: All patients with severe pelvic fracture admitted to the trauma unit between 1998 and 2004 underwent contrast enhanced MDCT prior to additional specific treatment. All patients with extravasation underwent immediate vascular embolization for hemodynamic stabilization. Orthopedic management was proposed when no contrast extravasation was demonstrated. The presence or absence of contrast extravasation on MDCT and the hemodynamic status of the patients were recorded. RESULTS: Seventy-four patients with pelvic fracture (mean age: 34 years) underwent contrast enhanced MDCT prior to therapeutic management. Vascular embolization was performed in 42 patients: 38 showed contrast extravasation and 4 were in hemodynamic shock but showed no extravasation. Orthopedic management was performed in 27 patients after negative MDCT and 5 hemodynamically stable patients with positive MDCT. CONCLUSION: In our patient population, the presence of iodinated contrast material extravasation at MDCT was a determinant factor in the selection of patients for vascular embolization.