title: Computed tomography angiography of lower extremities in the emergency room for evaluation of patients with gunshot wounds.
abstract: OBJECTIVE
  To assess the role of CT angiography in the evaluation of patients with lower extremity gunshot wounds in the emergency room.
  
  
  METHODS
  Eighty patients (73 male, 7 female, mean age 26 years) underwent CT angiography for the evaluation of lower extremity gunshot injuries. Imaging was conducted on the basis of standardized protocols utilizing 16-slice and 64-slice multidetector systems and images were qualitatively graded and assessed for various forms of arterial injury.
  
  
  RESULTS
  CT angiography findings indicative of arterial injury were observed in 24 patients (30%) and a total of 43 arterial injuries were noted; the most common form was focal narrowing/spasm (n = 16, 37.2%); the most common artery involved was the superficial femoral artery (n = 12, 50%). In qualitative assessment of images based on a 4-point grading system, both readers considered CT angiography diagnostically excellent (grade 4) in most cases. Surgical findings were consistent with CT angiography and follow-up of patients' medical records showed no arterial injuries in patients with normal findings on initial imaging.
  
  
  CONCLUSIONS
  Our findings demonstrate that CT angiography is an effective imaging modality for evaluation of lower extremity gunshot wounds and could help limit more invasive procedures such as catheter angiography to a select group of patients.
  
  
  CONCLUSIONS
  • CT angiography efficiently evaluates lower extremity gunshot wounds. • CT angiography provides image quality sufficiently reliable for assessment of gunshot injuries. • CT angiography could help limit invasive procedures to select patients.
authors.affiliation: Diagnostic Cardiovascular Imaging, Department of Radiological Sciences, University of California, Los Angeles, CA, USA, aliadibi2009@yahoo.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Adibi
authors.forename: Mayil S
authors.initials: MS
authors.lastname: Krishnam
authors.forename: Sumudu
authors.initials: S
authors.lastname: Dissanayake
authors.forename: Adam N
authors.initials: AN
authors.lastname: Plotnik
authors.forename: Kiyarash
authors.initials: K
authors.lastname: Mohajer
authors.forename: Cesar
authors.initials: C
authors.lastname: Arellano
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Ruehm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000293:injuries; D006801:Humans; D007869:Leg Injuries / Q000000981:diagnostic imaging*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009104:Multiple Trauma; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000293:injuries; D015203:Reproducibility of Results; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000293:injuries; D015599:Trauma Severity Indices; D057772:Vascular System Injuries / Q000000981:diagnostic imaging*; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging*; D055815:Young Adult