Aims and objectives
Our institution routinely uses CT angiography instead of conventional angiography to evaluate multiple vascular territories in the setting of trauma.
Angiography was previously considered the gold standard and the first-line imaging modality to assess vascular injury; now is only used to complement inconclusive CT examinations.
CT angiography is the recommended primary imaging modality to evaluate trauma patients: it can characterize correctly most of the detected arterial injuries,
demonstrating the extent,
location,
and type of arterial lesion,
with excellent negative predictive value.
Furthermore it has the...
Methods and materials
We retrospectively reviewed our hospital’s archiving system to identify all patients who had undergone a single bolus polytrauma CT between November 2016 and September 2017.
All CT examinations were performed with a 64-detector CT scanner.
CT acquisition parameters were as follows: section thickness (2 mm with reconstruction interval of 0.5-1.5mm),
pitch (0.609),
rotation time (0.5 second),
collimation (0.625x64mm),
120 kVp and 250 mAs.
The patient is placed on the scanner table in a supine position,
feet first; the scanning protocol begins with a scout image...
Results
We identified 22 patients with positive CT (17 male,
5 female; mean age 40 ± 10 years).
The mechanism of trauma was blunt in 19 patients(86%) and penetrating in 3 patients (14%).
Mechanisms of blunt trauma were motor vehicle accident (n=8),
fall from height (n=5),
pedestrian struck (n=2) and crush injury (n =4).
All obtained images show excellent diagnostic quality,
also in visualization of the distal pedal arteries.
3D,
and MPR-MIP images were always obtained.
The arterial tree of lower extremity was divided into 14...
Conclusion
Our study demonstrated the ability to detect important lower extremity arterial injuries during the first and unique phase of multiphasic whole-body trauma CT,
with a single bolus of contrast material.
A wide range of arterial injuries were detected and all major injuries requiring surgical exploration or repair were accurately detected and characterized.
No false-negative CT angiographic studies were identified.
One of the limits was to differentiate spasm from true arterial injury because both may appear as focal or diffuse narrowing.
Diagnostic conventional angiography may be...
Personal information
Authors:C.
A.
Di Ciesco1,
A.
Affinita 2,
E.
Mengozzi 2,
A.
Bruno 1,
N.
Montanari 2,
M.
Imbriani 2.
1.
Cardio-Thoracic Radiology Unit,
Department of Experimental,
Diagnostic and Specialty Medicine,
S.
Orsola- Malpighi Hospital,
"Alma Mater Studiorum" University of Bologna,
Italy
2.Department of Radiology,
Maggiore Hospital,
Bologna,
Italy
Correspondence to: Carmela Anna Di Ciesco
e-mail:
[email protected]
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