Vascular injuries of the neck and thoracic inlet: helical CT-angiographic correlation.
Imaging evaluation of patients suspected to have arterial injuries of the neck has traditionally been performed by using conventional angiography as an alternative to surgical exploration. However, there has been recent interest in and growing experience with use of noninvasive imaging techniques for the assessment of vascular injuries. Contrast material-enhanced helical computed tomographic (CT) angiography is increasingly being used to evaluate trauma patients in stable condition who are at risk for vascular injuries. It allows characterization of traumatic vascular lesions in the neck such as partial or complete occlusion, pseudoaneurysm, intimal flap, dissection, and arteriovenous fistula. In the same setting, CT angiography provides valuable additional information about the cervical soft tissues, aerodigestive tract, spinal canal, and spinal cord. In cases of penetrating gunshot injuries, the trajectory of the bullet and the locations of fragments can be assessed. CT angiography may be limited by artifacts from metallic fragments and occasionally by abundant soft-tissue air or streak artifacts in the shoulders. In such cases, conventional angiography is necessary for optimal assessment of vascular injuries. CT angiography can be used as a noninvasive alternative to conventional angiography in patients suspected to have vascular injuries but without initial indications for surgical treatment.
Núñez
Diego B
DB
Department of Radiology, Hospital of Saint Raphael, Yale University School of Medicine, 1450 Chapel St, New Haven, CT 06511, USA. dnunez@srhs.org
Torres-León
Mario
M
Múnera
Felipe
F
D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology; D000792:Angiography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D016477:Artifacts; D001808:Blood Vessels / Q000293:injuries*; D020212:Carotid Artery Injuries / Q000150:complications / Q000000981:diagnostic imaging; D003287:Contrast Media; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D009333:Neck / Q000098:blood supply; D019838:Neck Injuries / Q000150:complications / Q000000981:diagnostic imaging*; D020521:Stroke / Q000209:etiology; D013898:Thoracic Injuries / Q000150:complications / Q000000981:diagnostic imaging*; D036542:Tomography, Spiral Computed; D014711:Vertebral Artery / Q000293:injuries; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging; D014951:Wounds, Stab / Q000000981:diagnostic imaging
D003287:Contrast Media