title: Use of 64-row multidetector CT angiography in blunt and penetrating trauma of the upper and lower extremities.
abstract: Computed tomographic (CT) angiography is rapidly becoming the preferred imaging test for the initial evaluation of patients suspected to have arterial injuries after blunt and penetrating trauma to the extremities. The increasingly widespread use of 64-row multidetector CT technology offers considerable benefits in extremity CT angiography in the trauma setting. These include the ability to generate isotropic data sets of long vascular territories, with the acquisition performed in a short time (10 seconds or less). Isotropic voxels make CT a fully multiplanar modality, a capability that is particularly useful for evaluating tortuous vessels. Sixty-four-row multidetector CT angiography of the extremities has the ability to demonstrate a variety of vascular injuries such as occlusion, pseudoaneurysm, active extravasation, and intimal dissection. Radiologists should be aware of the various potential pitfalls and limitations of extremity CT angiography in evaluation of trauma patients suspected to have extremity vascular injuries, including inadequate arterial enhancement, motion artifact, inadequate positioning, and streak artifact. By demonstrating the extent, location, and type of injury, CT angiography aids in the decision-making process to determine the appropriate management for each injury in each patient.
authors.affiliation: Department of Radiology, Boston Medical Center, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118, USA. Sabrina.Pieroni@bmc.org
authors.forename: Sabrina
authors.initials: S
authors.lastname: Pieroni
authors.forename: Bryan R
authors.initials: BR
authors.lastname: Foster
authors.forename: Stephan W
authors.initials: SW
authors.lastname: Anderson
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Kertesz
authors.forename: James T
authors.initials: JT
authors.lastname: Rhea
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Soto
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000792:Angiography / Q000379:methods*; D001132:Arm / Q000098:blood supply; D001134:Arm Injuries / Q000000981:diagnostic imaging*; D001158:Arteries / Q000293:injuries*; D016477:Artifacts; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007866:Leg / Q000098:blood supply; D007869:Leg Injuries / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D036542:Tomography, Spiral Computed / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging*; D055815:Young Adult