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Impact of MDCT Angiography on the Use of Catheter Angiography for the Assessment of Cervical Arterial Injury After Blunt or Penetrating Trauma

Joshua W. Stuhlfaut1, Glenn Barest1, Osamu Sakai1, Brian Lucey1 and Jorge A. Soto1

1 Department of Radiology, Boston Medical Center, 88 East Newton St., Boston, MA 02118.



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  		Fig. 1A —CT angiograms in 26-year-old man with gunshot wound to neck. Axial source image (A) and sagittal multiplanar reformation (B) show occlusion of left internal carotid artery (arrows), despite beam-hardening artifact from bullet fragments retained in neck. This patient was managed conservatively without further imaging or intervention.

 


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  		Fig. 1B —CT angiograms in 26-year-old man with gunshot wound to neck. Axial source image (A) and sagittal multiplanar reformation (B) show occlusion of left internal carotid artery (arrows), despite beam-hardening artifact from bullet fragments retained in neck. This patient was managed conservatively without further imaging or intervention.

 


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  		Fig. 2A —CT angiogram and 3D volume-rendered reconstruction in 28-year-old woman with gunshot injury to neck. Axial source image (A) and 3D reconstruction (B) show dissection (arrows) of left internal carotid artery with associated pseudoaneurysm (arrowheads). This injury was repaired by endovascular coil embolization.

 


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  		Fig. 2B —CT angiogram and 3D volume-rendered reconstruction in 28-year-old woman with gunshot injury to neck. Axial source image (A) and 3D reconstruction (B) show dissection (arrows) of left internal carotid artery with associated pseudoaneurysm (arrowheads). This injury was repaired by endovascular coil embolization.

 


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  		Fig. 3A —CT angiogram and 3D volume-rendered reconstructions in 29-year-old woman after fall down stairs. Axial source image (A) and 3D reconstruction (B) show pseudoaneurysm (arrows) emanating from left lingual artery.

 


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  		Fig. 3B —CT angiogram and 3D volume-rendered reconstructions in 29-year-old woman after fall down stairs. Axial source image (A) and 3D reconstruction (B) show pseudoaneurysm (arrows) emanating from left lingual artery.

 

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