HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rieger, M. Articles by Jaschke, W. R. Search for Related Content PubMed PubMed Citation Articles by Rieger, M. Articles by Jaschke, W. R. Social Bookmarking                      What's this?

Traumatic Arterial Injuries of the Extremities: Initial Evaluation with MDCT Angiography

¹ Department of Radiology, Kurt Amplatz Center, Innsbruck University Hospital, Innsbruck 6020, Austria.
² Department of Radiology II, Innsbruck University Hospital, Anichstrasse 35, Innsbruck 6020, Austria.
³ Department of Vascular Surgery, Innsbruck University Hospital, Innsbruck 6020, Austria.
⁴ Department of Trauma Surgery, Innsbruck University Hospital, Innsbruck 6020, Austria.

OBJECTIVE. The purpose of this study was to retrospectively assess the accuracy of MDCT angiography as the initial diagnostic technique to depict arterial injury in patients with extremity trauma.

MATERIALS AND METHODS. Over 36 months, 87 patients (16 females and 71 males; age range, 16-87 years) with clinically suspected arterial injury after extremity trauma underwent 4-MDCT angiography and 67 ultimately underwent surgery. Eighty patients had blunt injuries, and seven had penetrating injuries. The presence of arterial involvement was investigated prospectively by the radiologist in charge and retrospectively by two independent radiologists. Each detected arterial lesion was then characterized as a spasm, stenosis, occlusion, or rupture. The standard of reference was surgery in 67 patients, angiography in two patients, and clinical and radiologic follow-up findings in 18 patients. MDCT angiography was assessed by means of receiver operating characteristic (ROC) curve analysis for lesion detection and Spearman's rank correlation test for lesion characterization. Image quality, lesion depiction, and artifacts were subjectively assessed.

RESULTS. Sixty-two traumatic arterial lesions were confirmed at surgery in 55 patients. MDCT angiography yielded high accuracy in detection (area under the ROC curve [A_z] = 0.96; p < 0.001) and characterization (r = 0.94; p < 0.001) of traumatic arterial injuries and in recognizing an underlying dissection (A_z = 0.82; p < 0.001). Prospective sensitivity and specificity were 95% and 87%, respectively, and retrospective sensitivity and specificity were 99% and 87%, respectively. MDCT angiography was considered to be sufficient for a reliable diagnosis in 83 patients (p < 0.001). Image quality and lesion depiction on MDCT angiograms were considered to be good and artifacts were considered mild with substantial interobserver agreement (, 0.62-0.69).

CONCLUSION. MDCT angiography provides significant and reproducible technique for the detection and characterization of arterial injuries to the extremities with high image quality and vascular delineation.

Keywords: angiography • arteriography • CT • extremities • MDCT • trauma

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				E. K. Fishman, K. M. Horton, and P. T. Johnson Multidetector CT and Three-dimensional CT Angiography for Suspected Vascular Trauma of the Extremities RadioGraphics, May 1, 2008; 28(3): 653 - 665. [Abstract] [Full Text] [PDF]

				A. M. Covey Invited Commentary RadioGraphics, May 1, 2008; 28(3): 665 - 666. [Full Text] [PDF]

				M. Karcaaltincaba MDCT angiography in patients with traumatic extremity injuries. Am. J. Roentgenol., July 1, 2006; 187(1): W129 - W129. [Full Text] [PDF]