@article{c95ec727699a4215b74636bb85f77ca1,
title = "Computed tomographic angiography for the diagnosis of blunt cervical vascular injury",
abstract = "Question: Is computed tomographic angiography (CTA) as effective as catheter angiography in diagnosing blunt cervical vascular injury (BCVI)? Design: Prospective cohort study. Setting: Trauma unit at an academic centre. Patients: Computed tomographic angiography was performed on 162 patients who sustained blunt trauma and met at least 1 criterion of a modification of the Denver screening criteria for blunt cerebrovascular injuries. Ninety percent of the patients (146) had these findings confirmed with standard catheter angiography. Description of test and diagnostic standard: Patients underwent CTA using a 16-channel CT scanner, and interpretation was performed using axial source images and 2-and 3-dimensional maximum-intensity pixel and volume reading display techniques. Catheter angiography of the head and neck, which is considered to be the gold standard, was performed using a Siemens Artis BA biplane neuroangiographic unit. An attending neuroradiologist performed both readings; CTA was primarily read without any knowledge of catheter angiography results. Main outcome: Sensitivity, specificity, positive and negative predictive values and accuracy of CTA. Results: Forty-six percent of BCVIs were identified among 43 patients. In 45 of 46 patients (98%), the results of CTA and catheter angiography were in agreement. There was a single falsenegative CTA; the remaining 103 patients had normal CTAs confirmed by normal catheter angiography. The sensitivity, specificity, positive predictive value, negative redictive value and accuracy of CTA for the diagnosis of BCVI were 97.7%, 100%, 100%, 99.3% and 99.3%, respectively. Conclusion: Computed tomographic angiography is an effective and sensitive diagnostic test for the detection of BCVIs.",
author = "McKenzie, {M. E.} and Andrew Kirkpatrick and David Evans and Wayne Meredith and Baxter, {N. N.} and Brasel, {K. J.} and Brown, {C. J.} and P. Chaudhury and Cogbill, {T. H.} and Cutter, {C. S.} and Dixon, {E. G.} and Fitzgerald, {G. W.N.} and Henteleff, {H. J.A.} and Kirkpatrick, {A. W.} and S. Latosinsky and A. MacLean and Mastracci, {T. M.} and McLeod, {R. S.} and A. Morris and Neumayer, {L. A.} and S. Smith and Temple, {L. R.}",
note = "Funding Information: Evidence-Based Reviews in Surgery (EBRS) is a program jointly sponsored by the Canadian Association of General Surgeons (CAGS) and the American College of Surgeons (ACS) and is supported by an educational grant from ETHICON and ETHICON ENDO-SURGERY, both units of Johnson & Johnson Medical Products, a division of Johnson & Johnson and ETHICON Inc. and ETHICON ENDO-SURGERY Inc., divisions of Johnson & Johnson Inc. The primary objective of EBRS is to help practising surgeons improve their critical appraisal skills. During the academic year, 8 clinical articles are chosen for review and discussion. They are selected for their clinical relevance to general surgeons and because they cover a spectrum of issues important to surgeons, including causation or risk factors for disease, natural history or prognosis of disease, how to quantify disease, diagnostic tests, early diagnosis and the effectiveness of treatment. A methodological article guides the reader in critical appraisal of the clinical article. Methodological and clinical reviews of the article are performed by experts in the relevant areas and posted on the EBRS website, where they are archived indefinitely. In addition, a listserv allows participants to discuss the monthly article. Surgeons who participate in the monthly packages can obtain Royal College of Physicians and Surgeons of Canada Maintenance of Certification credits and/or continuing medical education credits for the current article only by reading the monthly articles, participating in the listserv discussion, reading the methodological and clinical reviews and completing the monthly online evaluation and multiple choice questions. ",
year = "2009",
month = jun,
language = "English (US)",
volume = "52",
pages = "243--245",
journal = "Canadian Journal of Surgery",
issn = "0008-428X",
publisher = "Canadian Medical Association",
number = "3",
}