Penetrating neck injuries: Helical CT angiography for initial evaluation

Felipe Múnera, Jorge A. Soto, Diana M. Palacio, Jorge Castañeda, Carlos Morales, Alvaro Sanabria, Juan E. Gutiérrez, Giovanni Garcia

Research output: Contribution to journalArticle

136 Citations (Scopus)

Abstract

PURPOSE: To report an experience with helical computed tomographic (CT) angiography as the initial procedure to rule out arterial lesions caused by penetrating neck injuries. MATERIALS AND METHODS: During 27 months, 175 patients were referred for helical CT angiography of the neck because of clinical suspicion of arterial injuries. The protocol included a 100-mL bolus of nonionic contrast material injected at 4.5 mL/sec, with 11-second scanning delay, 3-mm collimation, and pitch of 1.3-2.0. CT images were interpreted prospectively by the emergency radiologist, and two radiologists retrospectively interpreted studies with consensus. Outcome was determined with examination of patients and their charts. The sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: Studies in two patients were considered inadequate for diagnosis; these patients were referred for conventional arteriography and had normal findings. In 27 patients (15.6%), arterial lesions were detected. One patient had two arterial injuries. Lesions demonstrated with helical CT angiography were arterial occlusion (n = 14), pseudoaneurysm (n = 8), pseudoaneurysm and arteriovenous fistulae (n = 4), and partial thrombosis (n = 2). The remaining 146 patients had normal arteries. On the basis of these findings, patients were treated with surgery (n = 21), endovascular intervention (n = 7), and observation alone (n = 146). CONCLUSION: Results indicate that helical CT angiography can be used as the initial method for evaluation in patients with possible arterial injuries of the neck.

Original languageEnglish (US)
Pages (from-to)366-372
Number of pages7
JournalRadiology
Volume224
Issue number2
StatePublished - 2002
Externally publishedYes

Fingerprint

Neck Injuries
Angiography
False Aneurysm
Arteriovenous Fistula
Wounds and Injuries
Contrast Media
Emergencies
Thrombosis
Neck
Arteries
Observation
Sensitivity and Specificity

Keywords

  • Arteries, injuries
  • Carotid arteries, angiography
  • Computed tomography (CT), angiography
  • Gunshot injuries

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Múnera, F., Soto, J. A., Palacio, D. M., Castañeda, J., Morales, C., Sanabria, A., ... Garcia, G. (2002). Penetrating neck injuries: Helical CT angiography for initial evaluation. Radiology, 224(2), 366-372.

Penetrating neck injuries : Helical CT angiography for initial evaluation. / Múnera, Felipe; Soto, Jorge A.; Palacio, Diana M.; Castañeda, Jorge; Morales, Carlos; Sanabria, Alvaro; Gutiérrez, Juan E.; Garcia, Giovanni.

In: Radiology, Vol. 224, No. 2, 2002, p. 366-372.

Research output: Contribution to journalArticle

Múnera, F, Soto, JA, Palacio, DM, Castañeda, J, Morales, C, Sanabria, A, Gutiérrez, JE & Garcia, G 2002, 'Penetrating neck injuries: Helical CT angiography for initial evaluation', Radiology, vol. 224, no. 2, pp. 366-372.
Múnera F, Soto JA, Palacio DM, Castañeda J, Morales C, Sanabria A et al. Penetrating neck injuries: Helical CT angiography for initial evaluation. Radiology. 2002;224(2):366-372.
Múnera, Felipe ; Soto, Jorge A. ; Palacio, Diana M. ; Castañeda, Jorge ; Morales, Carlos ; Sanabria, Alvaro ; Gutiérrez, Juan E. ; Garcia, Giovanni. / Penetrating neck injuries : Helical CT angiography for initial evaluation. In: Radiology. 2002 ; Vol. 224, No. 2. pp. 366-372.
@article{f1d85a7d4b7d4cfdb2d8c8d252c291f4,
title = "Penetrating neck injuries: Helical CT angiography for initial evaluation",
abstract = "PURPOSE: To report an experience with helical computed tomographic (CT) angiography as the initial procedure to rule out arterial lesions caused by penetrating neck injuries. MATERIALS AND METHODS: During 27 months, 175 patients were referred for helical CT angiography of the neck because of clinical suspicion of arterial injuries. The protocol included a 100-mL bolus of nonionic contrast material injected at 4.5 mL/sec, with 11-second scanning delay, 3-mm collimation, and pitch of 1.3-2.0. CT images were interpreted prospectively by the emergency radiologist, and two radiologists retrospectively interpreted studies with consensus. Outcome was determined with examination of patients and their charts. The sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: Studies in two patients were considered inadequate for diagnosis; these patients were referred for conventional arteriography and had normal findings. In 27 patients (15.6{\%}), arterial lesions were detected. One patient had two arterial injuries. Lesions demonstrated with helical CT angiography were arterial occlusion (n = 14), pseudoaneurysm (n = 8), pseudoaneurysm and arteriovenous fistulae (n = 4), and partial thrombosis (n = 2). The remaining 146 patients had normal arteries. On the basis of these findings, patients were treated with surgery (n = 21), endovascular intervention (n = 7), and observation alone (n = 146). CONCLUSION: Results indicate that helical CT angiography can be used as the initial method for evaluation in patients with possible arterial injuries of the neck.",
keywords = "Arteries, injuries, Carotid arteries, angiography, Computed tomography (CT), angiography, Gunshot injuries",
author = "Felipe M{\'u}nera and Soto, {Jorge A.} and Palacio, {Diana M.} and Jorge Casta{\~n}eda and Carlos Morales and Alvaro Sanabria and Guti{\'e}rrez, {Juan E.} and Giovanni Garcia",
year = "2002",
language = "English (US)",
volume = "224",
pages = "366--372",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

TY - JOUR

T1 - Penetrating neck injuries

T2 - Helical CT angiography for initial evaluation

AU - Múnera, Felipe

AU - Soto, Jorge A.

AU - Palacio, Diana M.

AU - Castañeda, Jorge

AU - Morales, Carlos

AU - Sanabria, Alvaro

AU - Gutiérrez, Juan E.

AU - Garcia, Giovanni

PY - 2002

Y1 - 2002

N2 - PURPOSE: To report an experience with helical computed tomographic (CT) angiography as the initial procedure to rule out arterial lesions caused by penetrating neck injuries. MATERIALS AND METHODS: During 27 months, 175 patients were referred for helical CT angiography of the neck because of clinical suspicion of arterial injuries. The protocol included a 100-mL bolus of nonionic contrast material injected at 4.5 mL/sec, with 11-second scanning delay, 3-mm collimation, and pitch of 1.3-2.0. CT images were interpreted prospectively by the emergency radiologist, and two radiologists retrospectively interpreted studies with consensus. Outcome was determined with examination of patients and their charts. The sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: Studies in two patients were considered inadequate for diagnosis; these patients were referred for conventional arteriography and had normal findings. In 27 patients (15.6%), arterial lesions were detected. One patient had two arterial injuries. Lesions demonstrated with helical CT angiography were arterial occlusion (n = 14), pseudoaneurysm (n = 8), pseudoaneurysm and arteriovenous fistulae (n = 4), and partial thrombosis (n = 2). The remaining 146 patients had normal arteries. On the basis of these findings, patients were treated with surgery (n = 21), endovascular intervention (n = 7), and observation alone (n = 146). CONCLUSION: Results indicate that helical CT angiography can be used as the initial method for evaluation in patients with possible arterial injuries of the neck.

AB - PURPOSE: To report an experience with helical computed tomographic (CT) angiography as the initial procedure to rule out arterial lesions caused by penetrating neck injuries. MATERIALS AND METHODS: During 27 months, 175 patients were referred for helical CT angiography of the neck because of clinical suspicion of arterial injuries. The protocol included a 100-mL bolus of nonionic contrast material injected at 4.5 mL/sec, with 11-second scanning delay, 3-mm collimation, and pitch of 1.3-2.0. CT images were interpreted prospectively by the emergency radiologist, and two radiologists retrospectively interpreted studies with consensus. Outcome was determined with examination of patients and their charts. The sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: Studies in two patients were considered inadequate for diagnosis; these patients were referred for conventional arteriography and had normal findings. In 27 patients (15.6%), arterial lesions were detected. One patient had two arterial injuries. Lesions demonstrated with helical CT angiography were arterial occlusion (n = 14), pseudoaneurysm (n = 8), pseudoaneurysm and arteriovenous fistulae (n = 4), and partial thrombosis (n = 2). The remaining 146 patients had normal arteries. On the basis of these findings, patients were treated with surgery (n = 21), endovascular intervention (n = 7), and observation alone (n = 146). CONCLUSION: Results indicate that helical CT angiography can be used as the initial method for evaluation in patients with possible arterial injuries of the neck.

KW - Arteries, injuries

KW - Carotid arteries, angiography

KW - Computed tomography (CT), angiography

KW - Gunshot injuries

UR - http://www.scopus.com/inward/record.url?scp=0036311540&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036311540&partnerID=8YFLogxK

M3 - Article

C2 - 12147829

AN - SCOPUS:0036311540

VL - 224

SP - 366

EP - 372

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -