Screening trauma patients with CT replaces angio

CT screening of head and neck vascular injuries by emergency departments could lead to more aggressive therapies that result in improved outcomes.

Dr. Grit Rademacher and colleagues from the Unfallkrankenhaus Berlin compared findings from ultrasound exams used to screen carotid arteries for injury with the results of CT angiography scans for the same indication. The ultrasound exams were acquired over five years and the CT scans over a one-year period.

The results were dramatic, Rademacher reported at the 2005 RSNA meeting. The ultrasound scans of 1471 patients produced a sensitivity of 38.5% and a specificity of 100%. One year after installation of a multislice CT device, CTA scans performed on 407 ER patients yielded a sensitivity of 100% and a specificity of 99.1%, with one false positive.

Today the facility's protocol calls for CTA in all instances of possible carotid trauma, Rademacher said. The team now skips traditional angiography and, after one year of experience, is confident that all injuries can be caught in the first scan.