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State-of-the-art 3DCT angiography assessment of lower extremity trauma: typical findings, pearls, and pitfalls

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Abstract

Multi-detector computed tomography angiography (MDCTA) of the lower extremities is an integral part of the decision-making process of lower extremity trauma. MDCTA can be integrated into multiphasic whole-body trauma MDCT and has replaced the traditional gold standard of catheter-based angiography as the preferred technique for the initial assessment of lower extremity trauma in many institutions worldwide. Advances in MDCT technology enable high speed simultaneous evaluation of both complete lower extremities, rapid image reconstruction, and advanced image visualization for the noninvasive and accurate diagnosis of vascular, including hematoma, active extravasation, vasospasm, stenosis, external compression, occlusion, intimal injury and dissection, arteriovenous fistulas, and pseudoaneurysm formation. In this exhibit, we outline the role of MDCTA in the management of lower extremity trauma, review current MDCT protocols and the practical use of advanced visualization techniques, and illustrate typical MDCTA findings, pearls, and pitfalls, which help to accurately characterize vascular injury and guide management.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, 21287, USA

    Jan Fritz & Elliot K. Fishman

  2. Department of Surgery, The Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, 21212, USA

    David T. Efron

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  1. Jan Fritz
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  2. David T. Efron
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  3. Elliot K. Fishman
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Correspondence to Elliot K. Fishman.

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Fritz, J., Efron, D.T. & Fishman, E.K. State-of-the-art 3DCT angiography assessment of lower extremity trauma: typical findings, pearls, and pitfalls. Emerg Radiol 20, 175–184 (2013). https://doi.org/10.1007/s10140-012-1094-4

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  • DOI: https://doi.org/10.1007/s10140-012-1094-4

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