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MDCT Angiography in Patients with Traumatic Extremity Injuries

Hacettepe University School of Medicine Ankara, Turkey

I read the article by Rieger et al. [1] in the March 2006 issue of the AJR with great interest. We also use MDCT angiography in patients with traumatic extremity injuries as an alternative to conventional angiography in our hospital, and our results are in accordance with those of the authors. However, I am surprised that the authors did not include studies with MDCT angiography even though they mentioned color Doppler sonography, MRI, and single-detector CT angiography for the evaluation of vascular injuries to the arms and legs [2, 3]. We also use this technique in pediatric patients for the evaluation of suspected extremity vascular injuries with similar results.

Although MR angiography can be used for this purpose, the advantage of CT is the depiction of associated bone fractures in addition to display of vascular injuries. Also, another common problem in patients with extremity injuries is the presence of other organ injuries that usually necessitates abdominal, chest, or cranial CT. We proposed an MDCT protocol in these patients in which extremity MDCT angiography and abdominal MDCT can be combined using a single contrast bolus [4]. In this protocol, the extremity is initially scanned at the arterial phase with MDCT angiographic parameters, and then abdomen or chest CT (or both) can be performed with the same contrast bolus, which obviates administration of additional contrast material in trauma patients.

I would like to congratulate the authors for their study, which hopefully will lead to the wider use of this technique in other institutions.

References

Top References

 

1. Rieger M, Mallouhi A, Tauscher T, Lutz M, Jaschke WR. Traumatic arterial injuries of the extremities: initial evaluation with MDCT angiography. AJR 2006;186 : 656-664[Abstract/Free Full Text]
2. Karcaaltincaba M, Akata D, Aydingoz U, et al. Three-dimensional MDCT angiography of the extremities: clinical applications with emphasis on musculoskeletal uses. AJR 2004;183 : 113-117[Free Full Text]
3. Bogdan MA, Klein MB, Rubin GD, McAdams TR, Chang J. CT angiography in complex upper extremity reconstruction. J Hand Surg Br 2004; 29:465 -469[Medline]
4. Karcaaltincaba M, Aydingoz U, Akata D, et al. Combination of extremity computed tomography angiography and abdominal imaging in patients with musculoskeletal tumors. J Comput Assist Tomogr2004; 28:273 -277[CrossRef][Medline]

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted 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 Google Scholar Google Scholar Articles by Karcaaltincaba, M. Search for Related Content PubMed PubMed Citation Articles by Karcaaltincaba, M. Social Bookmarking                      What's this?