Imaging of Vascular Injuries of the Extremities

Abstract

Multidetector computed tomography angiography (MDCTA) of the upper and lower extremities is the standard of care in the assessment of trauma patients with vascular trauma of the upper and lower extremities. A MDCTA of the extremities is typically integrated into multiphasic whole-body computed tomography trauma protocols in patients with suspected vascular injury. MDCTA has replaced catheter-directed digital subtraction angiography (DSA) as the modality of choice for the initial detection and characterization of vascular injuries because it is readily available, noninvasive, and faster than DSA. Understanding the imaging findings and pitfalls of upper and lower extremity MDCTA is essential in the diagnosis of vascular injuries such as active hemorrhage, vasospasm and stenosis, hematoma, occlusion and thrombosis, posttraumatic arteriovenous fistula, pseudoaneurysm, and patterns of intimal injury including dissection. We discuss the diagnosis and characterization of vascular injuries of the upper and lower extremities using MDCTA including derived multiplanar reconstructions, maximum intensity projection, and three-dimensional volume rendering techniques.

Popliteal Artery-Related Pathologies in Athletes—A Primer for Musculoskeletal Radiologists

“…Digital subtraction angiography (DSA) can provide advanced diagnostic and therapeutic to confirm the diagnosis. 9 10 …”

“…Digital subtraction angiography (DSA) can provide advanced diagnostic and therapeutic to confirm the diagnosis. 9,10 Popliteal Artery Entrapment Syndrome PAES is a vascular compression syndrome caused by an aberrant course of the popliteal artery or an accessory muscular slip (type I through V) compressing the artery (►Fig. 5A and B) or hypertrophied medial gastrocnemius compressing the popliteal artery on a functional basis (type VI) (►Fig.…”