Baltimore researchers have concluded that blunt cerebrovascular injury (BCVI) patients who undergo whole body multi-detector CTs (MDCT) do not generally need follow-up neck MDCT angiography. The University of Maryland Medical Center and R. Adams Cowley Shock Trauma Center in Baltimore have finished a study that reviewed the use of neck MDCT angiography exams after blunt trauma patients were suspected to have BCVIs.

Neck MDCT angiographies are the more common diagnostic techniques for cerbrovascular injuries. Because such injuries, though rare, hold potential for further complications (i.e., arteriovenous fistula or pseudoaneurysms) that lead to stroke or even death, accurate diagnosis in the presentation of BCVI symptoms is vital. Previously, standard procedure after indications of BCVI were detected in a whole body scan would be an order for a further neck MDCTA to confirm injuries.

Researchers studied over a hundred BCVI patients who underwent whole-body MDCT or neck MDCT. The examinations were compared with the results extracted from angiography reports to estimate the accuracy of each protocol for detecting BCVI injuries. Both techniques proved statistically similar in detecting carotid and vertebral artery injuries, according to Clint Sliker, M.D. of the University of Maryland, leader of the 23-month study.
Dr. Sliker explained that the implications for the results of the study mean that the whole body MDCT is a reliable initial screening tool for diagnosis and treatment of BCVI for those patients who do not present either typical symptoms or risk factors for such injuries. The reliability allows facilities to comfortably make decisions to forgo further follow-up neck MDCT screening.

The full study appeared in the March issue of the American Journal of Roentgenology.

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