Colour-flow ultrasound in the detection of penetrating vascular injuries of the neck.
OBJECTIVE
To determine the sensitivity of colour-flow ultrasound in the detection of penetrating vascular injuries of the neck when compared with conventional angiography.


METHODS
We prospectively imaged the neck arteries of all patients with suspected vascular injuries who were referred for angiography by the vascular surgeon over a 6-month period. All sonograms were performed by the same radiologist before angiography using a 7.5 or 10 MHz transducer on the same scanner. Data recorded were the presence or absence of vascular injury, the site of injury, and the type (intimal, dissection, false aneurysm or fistula). Angiography was performed immediately afterwards by a different radiologist. Results were correlated with the angiogram and operative findings.


RESULTS
25 patients were studied. 15 patients had normal ultrasound studies and angiograms. Ultrasound studies were positive in 10 patients (40%), with false aneurysms and arteriovenous fistulas detected in 8 patients; these were confirmed on angiography and at operation. There were intimal injuries in 2 patients (4%) that were undetected on angiography but confirmed at surgery. There were no false-positive or false-negative ultrasound studies.


CONCLUSIONS
Colour-flow ultrasound is sensitive in detecting vascular injuries and is suitable as a screening investigation in patients with penetrating neck injuries.
Corr
P
P
Department of Radiology, University of Natal, Durban.
Abdool Carrim
A T
AT
Robbs
J
J
D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging; D000792:Angiography; D001158:Arteries / Q000000981:diagnostic imaging / Q000293:injuries; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D019838:Neck Injuries / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging*; D014951:Wounds, Stab / Q000000981:diagnostic imaging*