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Dreizin D, Smith EB, Champ K, Morrison JJ. Roles of Trauma CT and CTA in Salvaging the Threatened or Mangled Extremity. Radiographics 2022; 42:E50-E67. [PMID: 35230918 PMCID: PMC8906352 DOI: 10.1148/rg.210092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Extremity arterial injuries account for up to 50% of all arterial traumas. The speed, accuracy, reproducibility, and close proximity of modern CT scanners to the trauma bay have led to the liberal use of CT angiography (CTA) when a limb is in ischemic jeopardy or is a potential source of life-threatening hemorrhage. The radiologist plays a critical role in the rapid communication of findings related to vessel transection and occlusion. Another role of CT that is often overlooked involves adding value to surgical planning. The following are some of the key questions addressed in this review: How does CTA help determine whether a limb is salvageable? How do concurrent multisystem injuries affect decision making? Which arterial injuries can be safely managed with observation alone? What damage control techniques are used to address compartment syndrome and hemorrhage? What options are available for definitive revascularization? Ideally, the radiologist should be familiar with the widely used Gustilo-Anderson open-fracture classification system, which was developed to prognosticate the likelihood of a functional limb salvage on the basis of soft-tissue and bone loss. When functional salvage is feasible or urgent hemorrhage control is required, communication with trauma surgeon colleagues is augmented by an understanding of the unique surgical, endovascular, and hybrid approaches available for each anatomic region of the upper and lower extremities. The radiologist should also be familiar with the common postoperative appearances of staged vascular, orthopedic, and plastic reconstructions for efficient clinically relevant reporting of potential down-range complications. Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- David Dreizin
- From the Division of Trauma and Emergency Radiology (D.D., E.B.S.), Department of Diagnostic Radiology and Nuclear Medicine (D.D., E.B.S., K.C.), and Department of Vascular Surgery (J.J.M.), University of Maryland and R Adams Cowley Shock Trauma Center, 655 W Baltimore St, Baltimore, MD 21201
| | - Elana B. Smith
- From the Division of Trauma and Emergency Radiology (D.D., E.B.S.), Department of Diagnostic Radiology and Nuclear Medicine (D.D., E.B.S., K.C.), and Department of Vascular Surgery (J.J.M.), University of Maryland and R Adams Cowley Shock Trauma Center, 655 W Baltimore St, Baltimore, MD 21201
| | - Kathryn Champ
- From the Division of Trauma and Emergency Radiology (D.D., E.B.S.), Department of Diagnostic Radiology and Nuclear Medicine (D.D., E.B.S., K.C.), and Department of Vascular Surgery (J.J.M.), University of Maryland and R Adams Cowley Shock Trauma Center, 655 W Baltimore St, Baltimore, MD 21201
| | - Jonathan J. Morrison
- From the Division of Trauma and Emergency Radiology (D.D., E.B.S.), Department of Diagnostic Radiology and Nuclear Medicine (D.D., E.B.S., K.C.), and Department of Vascular Surgery (J.J.M.), University of Maryland and R Adams Cowley Shock Trauma Center, 655 W Baltimore St, Baltimore, MD 21201
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Jin Z, Shen L, Zhao H, Zheng Y, Shen J. Application of Multi-Slice Spiral CT in the Evaluation of Diffuse Lung Diseases. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article analyzes the manifestations, characteristics, and significance of multi-slice spiral CT for diffuse lung disease, and evaluates the diagnostic value of multi-slice CT multi-directional reconstruction for diffuse lung disease. After performing multi-slice spiral CT examination
on the patient and collecting relevant data, the characteristic multi-slice CT imaging findings of diffuse lung disease were determined by statistical analysis. Diffuse lung disease is representative in multi-slice spiral CT image imaging manifestations of the disease include multiple disseminated
small nodules, multiple voids, ground glass shadows, and lung consolidation. And analyze the correlation of image performance, and then use statistical methods to analyze and evaluate the value of multi-slice spiral CT characteristic images in the diagnosis of diffuse lung disease, and analyze
the characteristics of these characteristic multi-slice CT image appearances. The use of high-resolution CT to screen the characteristic CT imaging findings of the same research object, and then to perform a statistical analysis of the diagnostic differences with multi-slice spiral CT, further
confirmed the importance of multi-slice CT for diffuse lung disease Diagnostic value. Studies have shown that multi-slice CT imaging technology is of great significance in the evaluation of diffuse lung diseases.
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Affiliation(s)
- ZanHui Jin
- Department of Radiology, The First People's Hospital of Huzhou & The First Affiliated Hospital of Huzhou Teachers College, Zhejiang, 313000, China
| | - LiYing Shen
- Department of Radiology, The First People's Hospital of Huzhou & The First Affiliated Hospital of Huzhou Teachers College, Zhejiang, 313000, China
| | - HongXing Zhao
- Department of Radiology, The First People's Hospital of Huzhou & The First Affiliated Hospital of Huzhou Teachers College, Zhejiang, 313000, China
| | - YinYuan Zheng
- Department of Radiology, The First People's Hospital of Huzhou & The First Affiliated Hospital of Huzhou Teachers College, Zhejiang, 313000, China
| | - Jian Shen
- Department of Radiology, Huzhou Central Hospital & Affiliated Cent Hosp HuZhou University, Zhejiang, 313000, China
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