Computed Tomography Angiography of Lower Extremities in the Emergency Room for Evaluation of Patients with Gunshot Wounds

Overview

Journal Eur Radiol

Specialty Radiology

Date 2014 May 9

PMID 24804632

Citations 3

Authors

Ali Adibi

Mayil S Krishnam

Sumudu Dissanayake

Adam N Plotnik

Kiyarash Mohajer

Cesar Arellano

Stefan G Ruehm

Affiliations

Soon will be listed here.

Abstract

Objective: To assess the role of CT angiography in the evaluation of patients with lower extremity gunshot wounds in the emergency room.

Materials And Methods: Eighty patients (73 male, 7 female, mean age 26 years) underwent CT angiography for the evaluation of lower extremity gunshot injuries. Imaging was conducted on the basis of standardized protocols utilizing 16-slice and 64-slice multidetector systems and images were qualitatively graded and assessed for various forms of arterial injury.

Results: CT angiography findings indicative of arterial injury were observed in 24 patients (30%) and a total of 43 arterial injuries were noted; the most common form was focal narrowing/spasm (n = 16, 37.2%); the most common artery involved was the superficial femoral artery (n = 12, 50%). In qualitative assessment of images based on a 4-point grading system, both readers considered CT angiography diagnostically excellent (grade 4) in most cases. Surgical findings were consistent with CT angiography and follow-up of patients' medical records showed no arterial injuries in patients with normal findings on initial imaging.

Conclusion: Our findings demonstrate that CT angiography is an effective imaging modality for evaluation of lower extremity gunshot wounds and could help limit more invasive procedures such as catheter angiography to a select group of patients.

Key Points: • CT angiography efficiently evaluates lower extremity gunshot wounds. • CT angiography provides image quality sufficiently reliable for assessment of gunshot injuries. • CT angiography could help limit invasive procedures to select patients.

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