title: Value of computed tomographic angiography in neck and extremity pediatric vascular trauma.
abstract: OBJECTIVE
  We sought to define the sensitivity and specificity of computed tomographic angiography (CTA) in pediatric vascular injuries.
  
  
  METHODS
  All neck and extremity CTAs performed in pediatric patients at a level 1 trauma center were reviewed from 2001 to 2007.
  
  
  RESULTS
  Overall, 78 patients were identified with an average age of 15.0 +/- 4.0 (0-18 years). Males outnumbered females 3.6:1. CTA was performed for 41 penetrating and 37 blunt traumas. Most penetrating injuries were due to missile wounds (71%) or stab wounds (17%). Eleven major vascular injuries resulted from penetrating trauma. For penetrating trauma, CTA was 100% sensitive and 93% specific. CTA for penetrating trauma had a positive predictive value (PPV) of 85% and negative predictive value (NPV) of 100%. Most blunt injuries were due to motor vehicle accidents (57%), followed by pedestrian hit by car (27%). Eight major vascular injuries resulted from blunt trauma. For blunt trauma, CTA was 88% sensitive and 100% specific. CTA for blunt trauma had a PPV of 100% and an NPV of 97%. The accuracy for penetrating and blunt trauma was 95% and 97%, respectively.
  
  
  CONCLUSIONS
  CTA is highly sensitive, specific, and accurate for pediatric neck and extremity vascular trauma.
authors.affiliation: DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery and Division of Trauma/Critical Care, University of Miami Miller School of Medicine, Miami, Fla 33136, USA.
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Hogan
authors.forename: Edward B
authors.initials: EB
authors.lastname: Lineen
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Perez
authors.forename: Holly L
authors.initials: HL
authors.lastname: Neville
authors.forename: William R
authors.initials: WR
authors.lastname: Thompson
authors.forename: Juan E
authors.initials: JE
authors.lastname: Sola
mesh_terms: D000293:Adolescent; D000792:Angiography; D001808:Blood Vessels / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005121:Extremities; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009333:Neck; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*