Aslan Assala, Eskew Joseph, Zaheri Spencer, Arceneaux Ridge, Field Elizabeth, Thibodeaux Elise, Roque Morgan, De Alba Luis, Arevalo Octavio, Cuellar Hugo
Louisiana State University Health Sciences Center , Shreveport, USA.
Emerg Radiol. 2025 Jan 14. doi: 10.1007/s10140-024-02310-5.
Computed tomography (CT) angiography is commonly utilized to quickly identify vascular injuries caused by blunt cervical trauma. It is often conducted alongside a cervical spine CT, based on established criteria. This study assessed the prevalence of cervical vascular injuries identified via CT angiography (CTA) in patients who had negative findings on cervical CT scans.
A retrospective study was performed on patients who experienced blunt trauma from January 2020 to December 2022 and underwent both cervical CT and CTA. The sample size was determined using the formula: n = (Z^2 * P * (1 - P)) / E^2, assuming a 99% confidence interval, a 2% margin of error, and a proportion of 0.05.
A total of 1,165 patients presented with acute blunt trauma to the head and neck during the study period. Out of those, 800 patients (68.7%) had negative cervical CT scans and only 5 patients (0.6%) were found to have vascular injuries on CTA, with an average age of 44.2 years. Regarding the severity of the injuries, three were classified as grade I and two as grade II. On the other hand, of the 365 patients with positive cervical CT, 44 patients (12%) had vascular injury on CTA, including 16 patients (4.5%) with grades III and IV injuries.
The findings of this study suggest that CTA in patients with negative cervical CT scans seldom reveals vascular injuries, with no injuries exceeding grade II. This highlights the selective utility of CTA in this patient group.
计算机断层扫描（CT）血管造影常用于快速识别钝性颈部创伤引起的血管损伤。根据既定标准，它通常与颈椎CT一起进行。本研究评估了颈椎CT扫描结果为阴性的患者中通过CT血管造影（CTA）识别出的颈部血管损伤的患病率。
对2020年1月至2022年12月期间遭受钝性创伤并接受颈椎CT和CTA检查的患者进行了一项回顾性研究。使用公式n = (Z^2 * P * (1 - P)) / E^2确定样本量，假设置信区间为99%，误差幅度为2%，比例为0.05。
在研究期间，共有1165例患者出现头颈部急性钝性创伤。其中，800例患者（68.7%）颈椎CT扫描结果为阴性，只有5例患者（0.6%）在CTA上被发现有血管损伤，平均年龄为44.2岁。关于损伤的严重程度，3例被分类为I级，2例为II级。另一方面，在365例颈椎CT阳性的患者中，44例患者（12%）在CTA上有血管损伤，包括16例（4.5%）III级和IV级损伤。
本研究结果表明，颈椎CT扫描结果为阴性的患者中，CTA很少显示血管损伤，且没有超过II级的损伤。这突出了CTA在该患者群体中的选择性应用。
