Multidetector CT evaluation of active extravasation in blunt abdominal and pelvic trauma patients.

Timely localization of a bleeding source can improve the efficacy of trauma management, and improvements in the technology of computed tomography (CT) have expedited the work-up of the traumatized patient. The classic pattern of active extravasation (ie, administered contrast agent that has escaped from injured arteries, veins, or urinary tract) at dual phase CT is a jet or focal area of hyperattenuation within a hematoma that fades into an enlarged, enhanced hematoma on delayed images. This finding indicates significant bleeding and must be quickly communicated to the clinician, since potentially lifesaving surgical or endovascular repair may be necessary.