Resolution of traumatic adrenal hemorrhage on CT: impact of follow-up timing and initial hematoma size.

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Harry Yip, Maryam Shekarfaroush, Demi Markakis, Humza Tufail, Adil Zia, Jan Gerstenmaier, Bruno Di Muzio
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Abstract

Purpose: Traumatic adrenal gland hemorrhage (TAH) is an uncommon injury which can be managed conservatively in most cases. There are limited studies assessing the interval follow-up and resolution of conservatively managed TAH. The aim of our study was to evaluate the relationship between resolution of TAH, follow-up imaging interval and initial hematoma size. A key objective was to assess the incidence of underlying adrenal masses that may mimic or contribute to hemorrhage.

Methods: Single centre retrospective cross-sectional study of all trauma patients with radiologically reported adrenal hemorrhage from January 1, 2009 to January 1, 2025. Patients were identified through radiology database search, with demographic, imaging and hematoma data collected to analyse associations between resolution, follow-up timing and initial hematoma size.

Results: Of the 246 patients identified, 125 (51%) underwent at least 1 follow-up CT. The first follow-up occurred at a mean interval of 66.9 days; At this time, 60 patients (48%) showed complete resolution, 53 (42%) showed partial resolution and 12 (10%) demonstrated persistent hemorrhage. An underlying adrenal lesion was identified in 1% of patients. There were statistically significant associations between follow-up imaging time interval and hematoma resolution (p = 0.0025), and between the initial hematoma size and the resolution outcome (p < 0.000001).

Conclusion: Complete resolution of TAH occurred more frequently in patients with follow-up imaging at ≥ 30 days post injury. Hematomas measuring < 27 mm on initial imaging were more likely to resolve completely. Underlying adrenal lesions were rare. These findings may assist trauma centres in refining follow-up imaging strategies for conservatively managed TAH.

外伤性肾上腺出血的CT诊断:随访时间和初始血肿大小的影响。
目的:外伤性肾上腺出血(TAH)是一种罕见的损伤,在大多数情况下可以保守治疗。有有限的研究评估间隔随访和解决保守管理TAH。我们的研究目的是评估TAH分辨率、随访影像间隔和初始血肿大小之间的关系。一个关键的目的是评估潜在的肾上腺肿块的发生率,可能模拟或促成出血。方法:对2009年1月1日至2025年1月1日所有经放射学报告肾上腺出血的创伤患者进行单中心回顾性横断面研究。通过放射学数据库搜索确定患者,收集人口统计学、影像学和血肿数据,分析消退、随访时间和初始血肿大小之间的关系。结果:在确定的246例患者中,125例(51%)接受了至少1次随访CT。第一次随访平均间隔66.9天;此时,60例(48%)患者完全消退,53例(42%)患者部分消退,12例(10%)患者持续出血。在1%的患者中发现潜在的肾上腺病变。随访时间间隔与血肿消退(p = 0.0025)、初始血肿大小与消退结果(p)之间存在统计学意义的相关性(p)。结论:损伤后≥30天随访影像学患者TAH完全消退的发生率更高。血肿测量
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来源期刊
Emergency Radiology
Emergency Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
4.60
自引率
4.50%
发文量
98
期刊介绍: To advance and improve the radiologic aspects of emergency careTo establish Emergency Radiology as an area of special interest in the field of diagnostic imagingTo improve methods of education in Emergency RadiologyTo provide, through formal meetings, a mechanism for presentation of scientific papers on various aspects of Emergency Radiology and continuing educationTo promote research in Emergency Radiology by clinical and basic science investigators, including residents and other traineesTo act as the resource body on Emergency Radiology for those interested in emergency patient care Members of the American Society of Emergency Radiology (ASER) receive the Emergency Radiology journal as a benefit of membership!
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