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Imaging primer for CT angiography in peripheral vascular trauma

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Abstract

The use of computed tomography angiography (CTA) for the evaluation of peripheral vascular trauma has become increasingly prevalent in the past decade with the development of multidetector CT (MDCT) and multiple studies subsequently demonstrating high sensitivity, specificity, and diagnostic accuracy when compared with conventional angiography. Additional benefits of MDCT include the ability to rapidly acquire the images, perform multiplanar and 3D reconstructions, and assess the adjacent soft tissues and bones. Rapid intravenous injection of iodinated contrast material is required for optimal arterial enhancement. CTA manifestations of an arterial injury may be direct, and include active contrast extravasation, pseudoaneurysm, arteriovenous fistula (AVF), intimal injury, dissection, or occlusion. There are also indirect signs which have a high association with vascular injury, and should raise suspicion, when present. Pitfalls related to image acquisition or patient factors can be mitigated with appropriate planning and post-processing techniques.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Lara Walkoff & Ashish Khandelwal

  2. Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Prashant Nagpal

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Walkoff, L., Nagpal, P. & Khandelwal, A. Imaging primer for CT angiography in peripheral vascular trauma. Emerg Radiol 28, 143–152 (2021). https://doi.org/10.1007/s10140-020-01826-w

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