Computed Tomography Angiography of the Upper Extremities

ACR Appropriateness Criteria® Clinically Suspected Vascular Malformation of the Extremities

“…Intravenous (IV) contrast administration improves lesion delineation and allows for the assessment of enhancement patterns, which may help narrow the differential diagnosis of a focal finding [3]. However, in general, MRI is the preferred imaging modality when evaluating suspected vascular malformations that are due to its greater soft-tissue contrast and ability to obtain dynamic flow information with MR angiography (MRA) [10].…”

“…CTA with IV contrast can be used to evaluate a suspected vascular malformation. It is generally of greater utility for a high-flow lesion, such as an arteriovenous malformation, as CTA is capable of delineating the feeding arteries, nidus, and draining veins, which typically characterize these lesions [10]. CTA may also provide some information in regards to lesion extent and invasion into muscular compartments and bones [10].…”

“…It is generally of greater utility for a high-flow lesion, such as an arteriovenous malformation, as CTA is capable of delineating the feeding arteries, nidus, and draining veins, which typically characterize these lesions [10]. CTA may also provide some information in regards to lesion extent and invasion into muscular compartments and bones [10]. However, MRI or MRA is the preferred method for suspected vascular malformation imaging due to superior soft-tissue contrast and potential for dynamic blood flow imaging [2,10,18].…”

“…CTA may also provide some information in regards to lesion extent and invasion into muscular compartments and bones [10]. However, MRI or MRA is the preferred method for suspected vascular malformation imaging due to superior soft-tissue contrast and potential for dynamic blood flow imaging [2,10,18].…”

“…Treatment approach spans the spectrum of conservative to aggressive options, which include compression dressings, sclerotherapy, transarterial or transvenous embolization, and surgical resection. Sclerotherapy is often used for low-flow lesions, whereas high-flow lesions are most effectively treated with embolization [8,10].…”