Vascular Injuries to the Neck After Penetrating Trauma: Diagnostic Performance of 40- and 64-MDCT Angiography

• DOI: 10.2214/ajr.14.14161
• Publication Date: 2015-09-23T14:04:26Z
• Authors: Uttam K. Bodanapally; David Dreizin; Clint W. Sliker; Alexis R. Boscak; Ramachandra P. Reddy
• Keywords: Digital subtraction angiography; External carotid artery

The purposes of this study were to assess the diagnostic performance 40- and 64-MDCT angiography with digital subtraction as reference standard in detection arterial injuries patients at high risk after penetrating neck trauma perform a separate analysis external carotid artery.In retrospective evaluation 53 sets angiograms from 51 injury, three reviewers unaware angiographic findings reviewed CT (CTA) images discern presence or absence injuries. Sensitivity specificity CTA calculated per artery was performed.Sensitivity for detecting ranged 75.7% (95% CI, 62.3-86.9%) 82.2% 69.5-92.1%). Specificity 96.4% 94.0-98.4%) 98.4% 96.0-100%). highly sensitive subgroup involving large-caliber vessels that contribute cerebral circulation. These sensitivities 92.8% 66-98.8%) 100% 76.6-100%) internal 88.9% 65.2-98.3%) 94.4% 72.6-99.0%) vertebral In contrast, sensitivity limited injuries, ranging 63.4% 45.5-79.5%) 70.0% 52.0-85.0%).CTA can be used initial may help guide management decisions if an injury is detected. Negative should not preclude close clinical follow-up, repeat evaluation, or, suspicion due wound trajectory, angiography.