Spectrum of multi-detector computed tomography imaging findings of thoracic vascular injuries secondary to blunt chest trauma: Correlation with vascular intervention and patient outcomes

SA Journal of Radiology

 
 
Field Value
 
Title Spectrum of multi-detector computed tomography imaging findings of thoracic vascular injuries secondary to blunt chest trauma: Correlation with vascular intervention and patient outcomes
 
Creator Langa, Sithembiso M. Dlamini, Nondumiso N.M. Pillay, Balasoobramanien
 
Subject Diagnostic Radiology Blunt chest trauma; MDCT findings; vascular injuries; vascular intervention; Durban.
Description Background: Thoracic vascular injuries following blunt chest trauma are the second leading cause of trauma-related deaths. Multi-detector computed tomography (MDCT) is the imaging modality of choice in detecting these injuries.Objectives: To determine the spectrum of vascular injuries detected on MDCT imaging in patients who sustained blunt chest trauma, and to assess the various types of management options and patient outcomes.Method: We retrospectively reviewed archived medical records of polytrauma patients who presented with blunt chest trauma and confirmed vascular injury on MDCT and vascular intervention images between May 2015 and August 2018 at Inkosi Albert Luthuli Central Hospital.Results: Thirty-nine patients with vascular injury findings were analysed. The injury spectrum comprised: 15 aortic injuries (AI), 19 non-aortic injuries (NAI), 4 combined (AI and NAI) and 1 aorto-venous injury. A majority of males (69%) with an overall mean age of 39 years constituted the study cohort. The commonest injury mechanisms included motor vehicle collisions (61%) and pedestrian accidents (28%); the remaining 11% were shared amongst motorbike accidents or falling from a moving train or a height. The subclavian artery (36%) was the most common anatomical location in the NAI and the frequent imaging finding was vessel occlusion (55%). The most common imaging findings in AI were the indirect signs (20.5%) followed by a grade III injury (15.4%). Six patients with a grade III AI were successfully managed with endovascular repair.Conclusion: A thorough knowledge of blunt vascular injury spectrums and imaging manifestations is critical when interpreting MDCT scans. Awareness of the mechanism of injury will trigger a high index of suspicion and probe a search for a vascular injury.
 
Publisher AOSIS
 
Contributor
Date 2019-07-23
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Qualitative research
Format text/html application/epub+zip application/xml application/pdf
Identifier 10.4102/sajr.v23i1.1709
 
Source South African Journal of Radiology; Vol 23, No 1 (2019); 11 pages 2078-6778 1027-202X
 
Language eng
 
Relation
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https://sajr.org.za/index.php/sajr/article/view/1709/2283 https://sajr.org.za/index.php/sajr/article/view/1709/2282 https://sajr.org.za/index.php/sajr/article/view/1709/2284 https://sajr.org.za/index.php/sajr/article/view/1709/2281
 
Coverage Africa; South Africa; KwaZulu-Natal; Durban May 2015- August 2018 Age; Gender; scan times; scan protocols; blunt trauma mechanisms; MDCT imaging findings; management; outcomes
Rights Copyright (c) 2019 Sithembiso M. Langa, Nondumiso N.M. Dlamini, Balasoobramanien Pillay https://creativecommons.org/licenses/by/4.0
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