Imaging of penetrating vascular trauma of the body and extremities secondary to ballistic and stab wounds

Gopireddy, Dheeraj Reddy; Kee-Sampson, Joanna; Vulasala, Sai Swarupa R; Stein, Rachel; Kumar, Sindhu; Virarkar, Mayur

doi:10.25259/jcis_99_2022

Cited by 7 publications

(5 citation statements)

References 100 publications

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“…Conversely, CT is the first-line modality in imaging penetrating injuries due to its high specificity and sensitivity and its ability to acquire multiplanar images relatively quickly [ 36 , 37 ]. CT angiography (CTA) is also often utilized to detect suspected vascular injury.…”

Section: Penetrating and Open Injuriesmentioning

confidence: 99%

Artificial intelligence in the detection of non-biological materials

Eibschutz,

Lu,

Abbassi

et al. 2024

Emerg Radiol

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Artificial Intelligence (AI) has emerged as a transformative force within medical imaging, making significant strides within emergency radiology. Presently, there is a strong reliance on radiologists to accurately diagnose and characterize foreign bodies in a timely fashion, a task that can be readily augmented with AI tools. This article will first explore the most common clinical scenarios involving foreign bodies, such as retained surgical instruments, open and penetrating injuries, catheter and tube malposition, and foreign body ingestion and aspiration. By initially exploring the existing imaging techniques employed for diagnosing these conditions, the potential role of AI in detecting non-biological materials can be better elucidated. Yet, the heterogeneous nature of foreign bodies and limited data availability complicates the development of computer-aided detection models. Despite these challenges, integrating AI can potentially decrease radiologist workload, enhance diagnostic accuracy, and improve patient outcomes.

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Section: Penetrating and Open Injuriesmentioning

confidence: 99%

Artificial intelligence in the detection of non-biological materials

Eibschutz,

Lu,

Abbassi

et al. 2024

Emerg Radiol

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“…Тривимірні техніки презентації даних дозволяють обертати зображення по довільно обраній осі, провести субтракцію (видалення елементів, які прикривають зображення, наприклад, кістки) й оцінку під різними кутами. Це є перевагою порівняно з можливостями традиційної артеріографії, при якій для того, щоб отримати кожну проєкцію, необхідно окремо ввести контраст і виконати серію знімків [2,6].…”

Section: косі проєкції в аналізі даних мультиспіральної комп'ютерної ...unclassified

“…Зазвичай при вогнепальних пораненнях для визначення оптимального плану втручання або неоперативного лікування при аналізі даних МСКТ використовуються аксіальні, корональні, сагітальні та 3D-реконструкції [5][6][7][8][9][10][11].…”

Section: обговоренняunclassified

Oblique projections in the analysis of multislice computed tomography data in gunshot wounds

Khoroshun,

Makarov,

Nehoduiko

et al. 2024

ЕМ

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Background. The purpose is to determine the place and role of oblique projections in the analysis of multislice computed tomography (MSCT) data in gunshot wounds. Materials and methods. More than 3,300 MSCT studies performed in wounded and traumatized patients over a certain period in the Military Medical Clinical Center of the Northern Region of the Medical Forces Command were prospectively studied. All the wounded were male, the average age was 42.1 ± 2.4 years. MSCT of the head, thoracic and abdominal organs, pelvis, and limbs was performed. The frequency of using oblique projections and their informativeness were studied. Results. A prospective study demonstrated that coronal, axial, sagittal projections, and 3D modeling were used in 100 % of cases, and in 21.4 % — oblique projections to improve MSCT results. The distribution by localization of MSCT was as follows: head — 32.9 %, neck — 7.6 %, chest organs — 32.2 %, abdominal organs — 22.3 %, limbs — 5.0 %. MSCT in angiomode was performed in 3.5 % of injured and traumatized patients: head — 27.2 %, neck — 18.4 %, chest organs — 28.9 %, abdominal organs — 23.7 %, limbs — 1.8 %. Oblique projections in MSCT data analysis were used when studying the wound channel in 82.3 % of cases, to improve the visualization of vessels during MSCT in angiomode — in 12.6 % and to improve the visualization of bone fracture lines — in 5.1 %. Conclusions. In the structure of MSCT studies, the head, thoracic organs, abdominal organs, neck, and limbs prevail by localization (in descending order). Oblique projections are used is 1/5 of cases and allow to improve the visualization of the direction of the wound channel, vessels during angiography and lines of flat and long tubular bone fractures.

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“…In the presence of hard signs, intervention (surgical or endovascular) is generally recommended, whereas soft signs indicate the need for further investigation. One must be aware that negative clinical examination does not rule out vascular trauma [ 6 , 7 ]. Proper clinical assessment can yield up to 80% of patients with vascular injury [ 8 ].…”

Section: Clinical Diagnosis Of Vascular Injurymentioning

confidence: 99%

“…It has the following limitations: missed injuries due to bony structures, open wounds, large haematomas, bulky dressings or splints, hindered access to the ultrasound probe and the fact that this test cannot be performed on patients with open wounds [ 20 ]. DUS is not reliable as a screening tool for blunt carotid vascular injury and cannot be used routinely for penetrating neck zone I and III injuries [ 7 ].…”

Section: Diagnostic Toolsmentioning

confidence: 99%

Diagnostic Approaches to Vascular Injury in Polytrauma—A Literature Review

Ntola

Hardcastle

2023

Diagnostics

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Background: Polytrauma is understood as significant injuries, occurring at the same time, to two or more anatomical regions (the ISS regions) or organ systems, with at least one of the injuries considered as posing a threat to life. Trauma is the main cause of unexpected demise in individuals below the age of 44 years and represents a huge burden on society. Vascular injury is highly morbid; it can lead to rapid exsanguination and death, posing a threat to both life and the limb. Independent predictors of outcome include mechanism of injury, associated injuries, and time from injury to definitive care. The mechanisms of vascular injury in the setting of polytrauma are either blunt, penetrating or a combination of the two. Methods: Comprehensive literature review of current diagnostic approaches to traumatic vascular injury in the context of polytrauma. The factors influencing the diagnostic approach are highlighted. The focus is the epidemiology of vascular injury and diagnostic approaches to it in the context of polytrauma. Results: Traumatic vascular injuries are associated with limb loss or even death. They are characterised by multiple injuries, the dilemma of the diagnostic approach, timing of intervention and higher risk of limb loss or death. The systematic approach in terms of clinical diagnosis and imaging is crucial in order save life and preserve the limb. The various diagnostic tools to individualise the investigation are discussed. Conclusion: This paper highlights the significance of timely and appropriate use of diagnostic tools for traumatic vascular trauma to save life and to preserve the limb. The associated injury also plays a crucial role in deciding the imaging modalities. At times, more than one investigation may be required.

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Imaging of penetrating vascular trauma of the body and extremities secondary to ballistic and stab wounds

Cited by 7 publications

References 100 publications

Artificial intelligence in the detection of non-biological materials

Artificial intelligence in the detection of non-biological materials

Oblique projections in the analysis of multislice computed tomography data in gunshot wounds

Diagnostic Approaches to Vascular Injury in Polytrauma—A Literature Review

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