Computed Tomography Angiography of the Extremities in Emergencies

CTA Imaging of Peripheral Arterial Injuries

Traumatic vascular injuries consist of direct or indirect damage to arteries and/or veins and account for 3% of all traumatic injuries. Typical consequences are hemorrhage and ischemia. Vascular injuries of the extremities can occur isolated or in association with major trauma and other organ injuries. They account for 1-2% of patients admitted to emergency departments and for approximately 50% of all arterial injuries. Lower extremities are more frequently injured than upper ones in the adult population. The outcome of vascular injuries is strictly correlated to the environment and the time background. Treatment can be challenging, notably in polytrauma because of the dilemma of which injury should be prioritized, and treatment delay can cause disability or even death, especially for limb vascular injury. Our purposes are to discuss the role of computed tomography angiography (CTA) in the diagnosis of vascular trauma and its optimized protocol to achieve a definitive diagnosis and to assess the radiological signs of vascular injuries and the possible pitfalls.

Applications of Vascular Imaging and Interventional Radiology Modalities in the Upper Extremity: A Review

Hand and upper extremity (HUE) vascular disorders are encountered frequently by hand surgeons in clinical practice. A wide array of imaging and vascular interventional radiology modalities exists for the diagnosis and treatment of HUE vascular disorders, some of which may not be familiar to the HUE surgeons. In this review article, we summarize the vascular imaging and vascular interventional radiology modalities and their relative advantages, disadvantages, and indications with respect to HUE pathology. We aim to familiarize HUE surgeons with the available types of diagnostic and therapeutic options for HUE vascular pathologies and aid interdisciplinary communication with vascular interventional radiology specialists during the clinical decision-making process.

Traumatic arterial injuries in upper and lower limbs: what every radiologist should know

Traumatic arterial injuries of the extremities are a rare but potentially fatal event. Computed tomography (CT) angiography of the extremities has become the technique of choice and can provide rapid accurate detection and characterization of vascular lesions. Vascular injuries can be classified in active hemorrhage, vasospasm, occlusion, post-traumatic arteriovenous fistula, pseudoaneurysm, and patterns of intimal injuries. The learning objectives of this pictorial essay are to review the normal arterial anatomy of the upper and lower limbs, describe the technique of CT angiography in vascular trauma of the extremities, describe and illustrate the CT-angiography findings of traumatic arterial injuries, and know the potential pitfalls when interpreting a CT-angiography of the extremities.

Cerebral aneurysm image segmentation based on multi-modal convolutional neural network

BACKGROUND AND OBJECTIVE

Accurate segmentation of cerebral aneurysms in computed tomography angiography (CTA) can provide an essential reference for diagnosis and treatment. This study aimed to evaluate a more helpful image segmentation method for cerebral aneurysms.

METHODS

Firstly, the original CTA images were filtered by Gaussian and Laplace, and both the processed image and original image constitute multi-modal images as input. Then, through multiple parallel convolution neural networks to multi-modal image segmentation. Eventually, all of the segmentation results were fused by linear regression to extract cerebral aneurysm and adjacent vessels.

RESULTS

The cerebral aneurysm and adjacent vessels were extracted correctly. When the threshold value is about 0.95, the overall performance of the segmentation effect is the best. The dice, accuracy, and recall rate were different in various combinations of the three extraction methods.

CONCLUSION

Multi-modal convolutional neural network can improve the segmentation accuracy by multi-modal processing of the original brain CTA image.

CT angiography of lower extremities from anatomy to traumatic and nontraumatic lesions: a pictorial review

After the introduction and the quick improvement of multidetector computed tomography technology, computed tomographic angiography (CTA) has become the imaging examination of choice for the first assessment of patients affected by lower extremities acute disorders. The widespread availability of CT equipment, the high temporal and spatial resolution with post-processing reformation possibilities represent the main advantages of this technique, which can reliably identify different findings related to arterial vessel pathology, such as occlusion, dissection, active bleeding, and pseudoaneurysm. Radiologists should know the anatomy, the acquisition protocols, and the CTA appearances of the different vascular lesions. The right interpretation of CTA findings is essential to establish the best treatment management of each patient.