AI Article Synopsis
- This study assessed the effectiveness of computed tomography angiography (CTA) in identifying injuries to the aerodigestive tract following penetrating neck injuries (PNI) and the impact of deep surgical emphysema on those results.
- Over four years, data from 383 patients were analyzed, revealing a high sensitivity (94.4%) and specificity (96.7%) for detecting vascular injuries through CTA.
- Deep surgical emphysema was closely correlated with digestive tract injuries, showing a sensitivity of 97.4% but lower specificity (63.5%), although the sensitivity reached 100% when ignoring minor injuries.
Article Abstract
Background: The purpose of this study was to audit our experience with computed tomography angiography (CTA) for the detection of aerodigestive tract injury (ADTI) following penetrating neck injury (PNI) and to assess the significance of deep surgical emphysema on CTA.
Methods: A prospectively maintained trauma registry at the Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg, South Africa was retrospectively interrogated. The data of all patients with PNI investigated with CTA over a 4-y period were reviewed. All findings of deep surgical emphysema were correlated to an aggregate standard of reference for ADTI as demonstrated by results from clinical examination, surgical neck exploration, endoscopy or contrasted swallow to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of this finding.
Results: A total of 383 patients underwent a CTA for PNI. A total of 94 vascular injuries were identified on 78 positive CTA studies. The sensitivity and specificity of CTA in detecting a vascular injury were 94.4% and 96.7%. Of the 383 patients investigated a total of 38 patients were diagnosed with digestive tract injury (DTI), and all of these patients were found to have deep surgical emphysema on CTA, except for one patient with a clinically insignificant oral cavity injury. Another 126 patients also had deep surgical emphysema on CTA but no DTI. The sensitivity, specificity, PPV, and NPV of deep surgical emphysema for the diagnosis of confirmed DTI in PNI were therefore 97.4%, 63.5%, 22.7%, and 99.5%, respectively. The sensitivity and NPV were, however, 100% when clinically insignificant injuries were excluded. Including patients with confirmed airway injuries and excluding all patients with pneumothoraces yielded a sensitivity, specificity, PPV, and NPV of 94.1%, 71.9%, 30.0%, and 98.9%, respectively, for the identification of ADTI. When excluding surgically irrelevant injuries, the sensitivity and NPV were again both 100%.
Conclusions: CTA for PNI has a high sensitivity and specificity for demonstrating vascular injury. The absence of deep surgical emphysema in the deep cervical fascial planes virtually excludes surgically significant ADTI. The presence of deep surgical emphysema is nonspecific but warrants further investigation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jss.2016.06.044 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Use of Acellular Dermal Matrix May Not Increase 30-Day Complications in Direct-to-Implant Breast Reconstruction: A Multi-institutional Analysis of 10,177 Cases.
Ann Plast Surg
January 2025
From the Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT.
Background: Direct-to-implant (DTI) breast reconstruction offers immediate aesthetic and psychological benefits, but the role of acellular dermal matrix (ADM) remains debated. Using a multi-institutional database, this study evaluates and compares outcomes between ADM-assisted and non-ADM DTI procedures.
Methods: The American College of Surgeons National Surgical Quality Improvement Program database from 2008 to 2022 was queried to identify female patients who underwent DTI breast reconstruction for oncological purposes.
Outcomes of 100 Squamous Cell Carcinomas of the Upper Limb: 100 Squamous Cell Carcinomas of the Upper Limb.
Ann Plast Surg
January 2025
From the Birmingham Hand Centre, University Hospital Birmingham, Birmingham, AL.
Background: Rates of recurrence, metastases, and mortality for squamous cell carcinoma (SCC) of the upper limb have not been clearly defined.
Objective: We aimed to characterize these tumors and assess the long-term outcomes, comparing with current literature.
Methods And Materials: A retrospective review was performed on 100 consecutive primary cutaneous upper limb SCCs managed surgically by a single hand surgeon between 2012 and 2019.
CD19-CAR T-cell therapy induces deep tissue depletion of B cells.
Ann Rheum Dis
January 2025
Department of Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg and Uniklinikum Erlangen, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg and Uniklinikum Erlangen, Erlangen, Germany, Erlangen, Germany. Electronic address:
Objectives: CD19-targeting chimeric antigen receptor (CAR) T-cell therapy can induce long-term drug-free remission in patients with autoimmune diseases (AIDs). The efficacy of CD19-CAR T-cell therapy is presumably based on deep tissue depletion of B cells; however, such effect has not been proven in humans in vivo.
Methods: Sequential ultrasound-guided inguinal lymph node biopsies were performed at baseline and after CD19-CAR T-cell therapy in patients with AIDs.
Incidence of Wounds Associated with Posterior Midline Incision for Achilles Tendon Pathology in a Large Cohort at a Tertiary Care Center.
J Am Podiatr Med Assoc
January 2025
†Podiatry, University of Pittsburgh Medical Center, Pittsburgh, PA.
Background: We sought to determine the wound complications associated with a straight midline incision overlying the Achilles tendon. Data on sex, age, body mass index (BMI), surgery performed, date of surgery, and wound development were collected.
Methods: We retrospectively collected data on 217 patients with a mean ± SD age of 46.
Deep Learning Superresolution for Simultaneous Multislice Parallel Imaging-Accelerated Knee MRI Using Arthroscopy Validation.
Radiology
January 2025
From the Department of Radiology, Division of Musculoskeletal Radiology, NYU Grossman School of Medicine, 660 1st Ave, 3rd Fl, Rm 313, New York, NY 10016 (S.S.W., J.V., R.K., E.H.P., J.F.); Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tübingen, University Hospital Tübingen, Tübingen, Germany (S.S.W.); Department of Radiology, University Hospital Basel, Basel, Switzerland (J.V.); Department of Radiology, Hospital do Coraçao, São Paulo, Brazil (T.C.R.); Academic Surgical Unit, South West London Elective Orthopaedic Centre (SWLEOC), London, United Kingdom (D.D.); Department of Radiology, Balgrist University Hospital, Zurich, Switzerland (B.F.); Department of Radiology, Jeonbuk National University Hospital, Jeonju, Republic of Korea (E.H.P.); Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea (E.H.P.); Medscanlagos Radiology, Cabo Frio, Brazil (A.S.); Centre for Data Analytics, Bond University, Gold Coast, Australia (S.E.S.); Siemens Healthineers AG, Erlangen, Germany (I.B.); and Siemens Medical Solutions USA, Malvern, Pa (G.K.).
Background Deep learning (DL) methods can improve accelerated MRI but require validation against an independent reference standard to ensure robustness and accuracy. Purpose To validate the diagnostic performance of twofold-simultaneous-multislice (SMSx2) twofold-parallel-imaging (PIx2)-accelerated DL superresolution MRI in the knee against conventional SMSx2-PIx2-accelerated MRI using arthroscopy as the reference standard. Materials and Methods Adults with painful knee conditions were prospectively enrolled from December 2021 to October 2022.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!