Multidetector CT and three-dimensional CT angiography for suspected vascular trauma of the extremities

The evolution of computed tomography (CT) from four to 16 to 64 sections since its inception in the late 1970s has led to more widespread use of this imaging modality in the emergent setting. CT angiography has become a crucial diagnostic technique for identifying vascular injury in the trauma patient. Regardless of the nature of the traumatic injury (eg, stab wound, gunshot wound, injury from a motor vehicle accident), use of multidetector CT with two-dimensional (2D) reformation and three-dimensional (3D) rendering allows visualization of injury to bone, muscle, and vasculature. The radiologist should be familiar with the indications for CT angiography, optimization of current multidetector CT acquisition protocols, utility of 2D and 3D displays, and CT findings in the presence of vascular injury to ensure prompt diagnosis and treatment.