Extremity CT angiography: application to trauma using 64-MDCT

Evolving multi-row detector computed tomography (MDCT) technology has resulted in increasing utility of CT angiography (CTA) in extremity vascular trauma diagnosis and characterization. Given the widespread availability as well as the ease of acquiring CTA in the trauma setting, CTA is increasingly...

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Bibliographic Details
Published in:Emergency radiology 2009-11, Vol.16 (6), p.425-432
Main Authors: Shah, Neil, Anderson, Stephan W., Vu, Michelle, Pieroni, Sabrina, Rhea, James T., Soto, Jorge A.
Format: Article
Language:English
Subjects:
Angiography - methods
Blood Vessels - injuries
Clinical Protocols
Contrast Media
Emergency Medicine
Extremities - diagnostic imaging
Extremities - injuries
Humans
Imaging
Imaging, Three-Dimensional
Medicine
Medicine & Public Health
Radiology
Review Article
Tomography, X-Ray Computed - methods
Trauma Centers
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Summary:Evolving multi-row detector computed tomography (MDCT) technology has resulted in increasing utility of CT angiography (CTA) in extremity vascular trauma diagnosis and characterization. Given the widespread availability as well as the ease of acquiring CTA in the trauma setting, CTA is increasingly being used as the initial diagnostic evaluation in extremity vascular trauma, replacing digital subtraction angiography in many institutions. One of the significant advantages of the application of 64-MDCT to extremity vascular trauma is the ability to integrate CTA into routine trauma torso protocols. This ultimately yields an efficient, tailored examination to evaluate the multi-trauma patient in a timely manner, a critical concern in this patient population. Although 64-MDCT offers increasing improvement in image quality, technical quality hinges on strict attention to protocol considerations in its implementation. This review article aims to detail the myriad injuries, which may be detected and characterized with CTA. Protocol considerations in the application of 64-MDCT technology to extremity vascular trauma are discussed, drawing from our experience in an urban, Level I trauma center. Finally, the advantages and techniques of integrating extremity CTA into torso trauma protocols will be described.
ISSN:1070-3004
1438-1435
DOI:10.1007/s10140-009-0805-y