Abstract:
HTML
Purpose: The purpose of this study was to assess the clinical usefulness of multi-detector row CT angiography (MDCTA), as the initial diagnostic modality, for the detection of arterial involvement in patients with a traumatic injury of the extremities.
Methods and Materials: Sixty-nine patients with clinically suspected arterial injury after an upper or lower extremity trauma underwent MDCTA of the involved extremity. MDCTA was performed by using 1.25-mm collimation and pitch 6 for the entire extremity or with pitch 3 when only a part of the extremity was examined. To investigate the presence of an arterial involvement, source images, multiplanar volume reformations (MPVR) and volume-rendered (VR) views were evaluated prospectively by the radiologist in charge and retrospectively by two independent radiologists. Each detected arterial lesion was then assessed to determine its morphology and extent. The diagnostic performance of MDCTA was assessed by means of ROC analysis for lesion detection and Spearman-Rho test for lesion characterization. The presence of an underlying dissection was also sought. Image quality, lesion depiction and vascular delineation were subjectively assessed.
Results: In 45 patients, 50 arterial traumatic injuries were confirmed at surgery. MDCTA achieved a significant performance in the detection (Az=0.91; P<.001) and characterization (r=0.93; P<.001) of arterial injuries after extremity trauma as well as in the recognition of an underlying dissection (Az, 0.82; P<.001). Prospective sensitivity and specificity were 96% and 88%, respectively, and retrospective sensitivity and specificity were 99% and 88%, respectively. Image quality, lesion depiction and vascular delineation on multi-detector row CT angiograms were considered to be good with at least substantial interobserver agreement (k, 0.62-0.85). Axial source images were found significantly (P<.001) adequate for the diagnosis of traumatic arterial injuries of the extremities and VR views were significantly (P<.001) more useful than MPVR images. MDCTA was considered to be sufficient for a reliable diagnosis in 65 patients (P<.001, non-parametric binominal test).
Conclusion: MDCTA enables a significant, and reproduceable detectability and characterization of extremities arterial injuries with high image quality and vascular delineation.
Questions about this event email: Ammar.Mallouhi@uibk.ac.at
Rieger MD, M,
Traumatic Arterial Injuries of the Extremities: Initial Evaluation with Multi-Detector Row CT Angiography. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3103565.html
