Diagnostic performance of helical CT angiography in trauma to large arteries of the extremities.
OBJECTIVE
The purpose of this work was to assess the performance of helical CT angiography (CTA) in the diagnosis of injuries to large arteries of the extremities.


METHODS
We performed helical CTA on 45 consecutive patients referred for conventional angiography for evaluation of suspected arterial injuries after sustaining trauma to the extremities (13 upper, 32 lower). Two radiologists interpreted the helical CTA studies independently. Diagnostic performance parameters evaluated included sensitivity, specificity, receiver operating characteristic (ROC) curves, and interobserver agreement (kappa statistics). Conventional angiography was used as the standard of reference for determination of final diagnoses.


RESULTS
Forty-three of 45 patients (96%) had diagnostic helical CTA examinations. Final diagnoses in these 43 patients were arterial occlusion (n = 7), partial obstruction (n = 3), pseudoaneurysm (n = 5), arteriovenous fistula (n = 1), pseudoaneurysm and arteriovenous fistula (n = 3), and normal findings (n = 24). Sensitivity and specificity were 90% [95% confidence interval (CI), 80-99] and 100% (95% CI, 99-100), respectively, for Reader 1 and 100% (95% CI, 99-100) and 100% (95% CI, 99-100), respectively, for Reader 2. ROC curve analysis revealed high diagnostic performance, with areas under the curve of >0.9 for both readers. Interobserver agreement was 0.9.


CONCLUSIONS
The diagnostic performance of helical CTA for detection of major injuries of large arteries of the extremities is high.
Soto
J A
JA
Department of Radiology, Universidad de Antioquia, Hospital Universitario San Vicente de Paul, Medellín, Colombia.
Múnera
F
F
Cardoso
N
N
Guarín
O
O
Medina
S
S
D000293:Adolescent; D000328:Adult; D000792:Angiography / Q000379:methods* / Q000706:statistics & numerical data; D001132:Arm / Q000098:blood supply / Q000000981:diagnostic imaging*; D001134:Arm Injuries / Q000000981:diagnostic imaging*; D001158:Arteries / Q000293:injuries*; D003287:Contrast Media; D006801:Humans; D007479:Iopamidol; D007866:Leg / Q000098:blood supply / Q000000981:diagnostic imaging*; D007869:Leg Injuries / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000706:statistics & numerical data; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging*
D003287:Contrast Media; D007479:Iopamidol