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CT angiography not adequate for cerebrovascular injury screening

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Compared with digital subtraction angiography, computed tomographic angiography is only about half as sensitive in identifying cerebrovascular injuries resulting from blunt trauma, reports a team at the University of Tennessee, Memphis.

In their paper in the March issue of the Annals of Surgery, the authors point out that unrecognized blunt cerebrovascular injury can lead to stroke in young trauma patients, and that many institutions have replaced digital subtraction angiography (DSA) with computed tomographic angiography (CTA) for blunt cerebrovascular injury screening.

To compare the diagnostic accuracy of CTA with DSA, Dr. Timothy C. Fabian and colleagues performed both evaluations in 684 trauma patients with risk factors for cerebrovascular injury. DSA of the head and neck was performed using Siemens AXIOM Artis biplane system while Toshiba Aquilion 32-channel computed tomography scanners were used for CTA.

DSA identified 105 cerebrovascular injuries in 90 patients, but CTA missed 53 of these injuries, according to the report. On analyzing the results, the investigators calculated that CTA