Shah Neil, Anderson Stephan W, Vu Michelle, Pieroni Sabrina, Rhea James T, Soto Jorge A
Boston University Medical School, Boston, MA 02218, USA.
Emerg Radiol. 2009 Nov;16(6):425-32. doi: 10.1007/s10140-009-0805-y. Epub 2009 Mar 20.
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.
不断发展的多排探测器计算机断层扫描（MDCT）技术使得CT血管造影（CTA）在四肢血管创伤诊断和特征描述中的应用越来越广泛。鉴于CTA在创伤环境中广泛可用且易于获取，它越来越多地被用作四肢血管创伤的初始诊断评估手段，在许多机构中取代了数字减影血管造影。将64排MDCT应用于四肢血管创伤的一个显著优势是能够将CTA整合到常规创伤胸部检查方案中。这最终能进行高效、针对性强的检查，以便及时评估多发伤患者，这对这类患者群体来说至关重要。尽管64排MDCT在图像质量上有不断的提升，但技术质量取决于在实施过程中对方案考量的严格关注。这篇综述文章旨在详细阐述通过CTA可能检测到并进行特征描述的各种损伤。借鉴我们在城市一级创伤中心的经验，讨论将64排MDCT技术应用于四肢血管创伤时的方案考量。最后，将描述把四肢CTA整合到胸部创伤方案中的优势和技术。
