Multi-Detector CT Scanner Angiography for Initial Evaluation of Neck Injuries
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- Category: Vol. 77, December 2009
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Multi-Detector CT Scanner Angiography for Initial Evaluation of Neck Injuries,KHALED FAWZY Z. HASSAN and INASSE IBRAHIM GABALLAH
Abstract
Aim of Study: To assess the diagnostic validity of multi-detector CT (MDCT) angiography.
Patients and Methods: We evaluated MDCT angiography in 57 patients (40 males and 17 females, mean age, 33.6±14.5 years; age range, 16-63 years), who were referred to the Radiology Department with trauma to the neck. They were hemodynamically stable. Diagnostic quality was scored as either ''diagnostic'', depending upon detection of enhanced blood vessels clearly, no artifacts and good background tissue. ''Nondiagnostic'' if blood vissues were unclear and/or presence of marked artifacts. It is also considered diagnostic when the common carotid artery, internal carotid artery, aortic arch branches as well as the vertebral arteries in both sides were readable. Patient outcome after admission to the hospital was used as the standard of reference for comparison with results of MDCT angiography.
Results: Two patients (3.5%) were ''nondiagnostic''. Ex-aminations for the remaining 55 patients (96.5%) were ''diag-nostic''. A total of 440 arteries were evaluated with MDCT angiography. Vascular injuries were present in 15 patients (27.3%), while the arteries were normal in 40 patients (72.7%). The details of injuries were relative unilateral stenosis of one vertebral artery (7, 12.7%), relative stenosis of one common carotid artery (4, 7.3%), incomplete common carotid throm-bosis (2, 3.6%), common carotid pseudoaneurysm (1, 1.8%), partial occlusion of internal carotid artery (1, 1.8%). The specificity of MDCT in cases with neck injuries was 95.2%, the sensitivity was 100%, positive predictive value was 88.2%, negative predictive value was 100%, while diagnostic accuracy was 96.5%.
Conclusions: MDCT angiography is a good alternative to conventional angiography for patients who are hemody-namically stable. It is a rapid, accurate, noninvasive technique and is less expensive than conventional angiography.
Recommendation: The high validity is an additional reason to prefer this low-risk, noninvasive and reproducible method as an initial diagnostic examination in these patients.