PURPOSE: To determine the sensitivity of colour-flow ultrasound in the detection of penetrating vascular injuries of the neck when compared with conventional angiography. METHOD: We prospectively imaged the neck arteries of all patients with suspected vascular injuries who were referred for angiography by the vascular surgeon over a 6-month period. All sonograms were performed by the same radiologist before angiography using a 7.5 or 10 MHz transducer on the same scanner. Data recorded were the presence or absence of vascular injury, the site of injury, and the type (intimal, dissection, false aneurysm or fistula). Angiography was performed immediately afterwards by a different radiologist. Results were correlated with the angiogram and operative findings. RESULTS: 25 patients were studied. 15 patients had normal ultrasound studies and angiograms. Ultrasound studies were positive in 10 patients (40%), with false aneurysms and arteriovenous fistulas detected in 8 patients; these were confirmed on angiography and at operation. There were intimal injuries in 2 patients (4%) that were undetected on angiography but confirmed at surgery. There were no false-positive or false-negative ultrasound studies. CONCLUSION: Colour-flow ultrasound is sensitive in detecting vascular injuries and is suitable as a screening investigation in patients with penetrating neck injuries.
PURPOSE: To determine the sensitivity of colour-flow ultrasound in the detection of penetrating vascular injuries of the neck when compared with conventional angiography. METHOD: We prospectively imaged the neck arteries of all patients with suspected vascular injuries who were referred for angiography by the vascular surgeon over a 6-month period. All sonograms were performed by the same radiologist before angiography using a 7.5 or 10 MHz transducer on the same scanner. Data recorded were the presence or absence of vascular injury, the site of injury, and the type (intimal, dissection, false aneurysm or fistula). Angiography was performed immediately afterwards by a different radiologist. Results were correlated with the angiogram and operative findings. RESULTS: 25 patients were studied. 15 patients had normal ultrasound studies and angiograms. Ultrasound studies were positive in 10 patients (40%), with false aneurysms and arteriovenous fistulas detected in 8 patients; these were confirmed on angiography and at operation. There were intimal injuries in 2 patients (4%) that were undetected on angiography but confirmed at surgery. There were no false-positive or false-negative ultrasound studies. CONCLUSION: Colour-flow ultrasound is sensitive in detecting vascular injuries and is suitable as a screening investigation in patients with penetrating neck injuries.
Authors: Charles E Ray; Shaun C Spalding; C Clay Cothren; Wei-Shin Wang; Ernest E Moore; Stephen P Johnson Journal: World J Emerg Surg Date: 2007-01-09 Impact factor: 5.469