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Neuroradiology |
1 From the Department of Radiology, Universidad de Antioquia, Hospital Universitario San Vicente de Paul, Calle 64 x Kra. 51D, Medellin, Colombia. Received July 12, 1999; revision requested August 25; revision received November 10; accepted December 6. Supported in part by Quimica Schering, Bogotá, Colombia. Address correspondence to F.M. (e-mail: fmunera@epm.net.co).
PURPOSE: To determine the sensitivity and specificity of helical computed tomographic (CT) angiography in the diagnosis of carotid and vertebral arterial injuries caused by penetrating neck trauma.
MATERIALS AND METHODS: A prospective study was conducted during 24 months in 60 patients with penetrating neck trauma who were referred for conventional angiography owing to clinical suspicion of arterial injury. In the patient population, 146 arteries (77 carotid, 69 vertebral) were studied by means of conventional angiography. In all patients, conventional angiography and helical CT angiography were completed within 6 hours. Two radiologists interpreted helical CT angiographic studies by means of consensus. Conventional angiography was the standard of reference for determining the sensitivity and specificity of helical CT angiography.
RESULTS: Conventional angiograms showed arterial injuries in 10 (17%) of 60 patients. Conventional angiographic findings were arterial occlusion (n = 4), arteriovenous fistula (n = 2), pseudoaneurysm (n = 3), pseudoaneurysm with arteriovenous fistula (n = 1), and normal arteries (n = 136). Nine of 10 arterial injuries and all normal arteries were depicted adequately at helical CT angiography. Sensitivity of helical CT angiography was 90%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 98%.
CONCLUSION: The sensitivity and specificity of helical CT angiography are high for detection of major carotid and vertebral arterial injuries resulting from penetrating trauma.
Index terms: Carotid arteries, angiography, 172.12113, 172.1245, 904.1222 • Carotid arteries, CT, 904.12916, 904.12917, 904.12919 • Carotid arteries, injuries, 904.411, 904.494, 904.73 • Computed tomography (CT), angiography, 904.12916 • Computed tomography (CT), clinical effectiveness, 904.12916 • Gunshot injuries, 904.411, 904.494, 904.73 • Vertebral arteries, CT, 1751.12113, 1751.12116, 901.12916, 901.12917 • Vertebral arteries, injuries, 1751.1243
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