Blunt cerebrovascular injury screening with 64-channel multidetector computed tomography

Abstract

Diagnostic study, level III.

Evaluation for Blunt Cerebrovascular Injury: Review of the Literature and a Cost-Effectiveness Analysis

“…29 There is great heterogeneity in the reported diagnostic performance of CTA and lack of uniform, unbiased comparison with DSA. Paulus et al 11 reported an improved sensitivity of 64-detector row CTA and 32-detector row CTA, with a sensitivity of 68% and a specificity of 92% in 594 patients who met the screening criteria for BCVI and underwent both CTA and DSA. However, there was no blinding or mention of whether the findings could be seen on CTA retrospectively.…”

“…9,10 Increasingly, CT angiography is used in emergency departments to assess patients. 11 There is considerable variation in the reported sensitivity of CTA for BCVI detection in the literature, and its ability to replace DSA has not been validated, to our knowledge. In a multidisciplinary survey in 2011, 60% of practitioners in North America reported using CTA for screening, while 15% continue to use DSA.…”

Blunt vertebral vascular injury in trauma patients: ATLS® recommendations and review of current evidence

“…Sensitivity and specificity has improved with the advent of higher resolution CT scanners (33 (9). The results were concordant in 98% of cases.…”

Screening for Pediatric Blunt Cerebrovascular Injury: Review of Literature and a Cost-Effectiveness Analysis

“…In the adult literature, this is a topic of immense controversy with recent literature quoting a low sensitivity of even 64 slice CTA compared to DSA. [25] In a meta-analysis comparing the accuracy of CTA against DSA for BCVI, Roberts et al reported a pooled sensitivity of 66% and specificity of 97%…”