Blunt cerebrovascular injury: Diagnosis at whole-body MDCT for multi-trauma

被引：13
作者：
Bonatti M. [1 ]
Vezzali N. [1 ]
Ferro F. [1 ]
Manfredi R. [2 ]
Oberhofer N. [3 ]
Bonatti G. [1 ]
机构：
[1] Department of Radiology, San Maurizio Hospital, 5 Boehler Street, Bolzano
[2] Department of Radiology, Policlinico G.B. Rossi, 10 L.A. Scuro Place, Verona
[3] Department of Physics, San Maurizio Hospital, 5 Boehler Street, Bolzano
来源：
Insights into Imaging | 2013年 / 4卷 / 3期
关键词：
Carotid artery injury; Multiple trauma; Spine; Spiral computed tomography; Vertebral artery dissection;
D O I：
10.1007/s13244-013-0235-y
中图分类号：
学科分类号：
摘要：
Purpose To analyse the prevalence of blunt cerebrovascular injuries (BCVIs) in multi-trauma patients by means of a post-contrast acquisition of neck vessels included into the whole-body multi-detector computed tomography (MDCT) protocol performed at admission and to correlate it with the presence of risk factors (Memphis approach). Materials and methods A retrospective study was undertaken for the period January 2005 to November 2011, involving 976 multi-trauma patients. Post-contrast images of neck vessels in MDCT scan were evaluated by two experienced radiologists; carotid, vertebral and basilar arteries were rated according to the Biffl classification. The presence of clinical and/or CT risk factors for BCVI was assessed. Results BCVI were present in 32/976 (3.3 %) multi-trauma patients. Risk factors for BCVI were present in 247/976 (25.3 %) patients. The group of patients presenting risk factors showed a significantly higher prevalence of cerebrovascular injuries (8.1 %) compared with the group of patients without risk factors (1.6 %) (p=0.009); however, 12/32 (37.5 %) patients presenting BCVI did not show any of the risk factors proposed by the Memphis group. Conclusion An investigation for the presence of BCVI should be performed on all multi-trauma patients despite the absence of clinical-radiological risk factors. Key Points • BCVIs are present in 3.3 % of multi-trauma patients. • BCVIs are significantly associated to the Memphis risk factors. • Of the multi-trauma patients affected by BCVIs, 37.5 % do not show clinical-radiological risk factors. • A screening for BCVI should be performed on all multitrauma patients. © The Author(s) 2013.
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页码：347 / 355
页数：8
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