AJR. American journal of roentgenology
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AJR Am J Roentgenol · Sep 1987
Role of CT in excluding major arterial injury after blunt thoracic trauma.
The role of CT in the diagnosis of major vascular rupture following blunt decelerating chest trauma is controversial. Its value in excluding major arterial injury has not yet been determined. During a 12-month period we obtained dynamic enhanced thoracic CT studies in 20 patients with blunt decelerating thoracic trauma who had abnormal or equivocal mediastinal contours on chest radiographs. ⋯ CT excluded direct vascular injury or mediastinal hematoma in 10 patients. All 10 had normal thoracic angiograms. This preliminary study suggests that, in patients sustaining blunt decelerating thoracic trauma, thoracic CT may be more valuable than chest radiography in excluding major vascular injury and, in some cases, may reduce the need for thoracic angiography.
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AJR Am J Roentgenol · Sep 1987
Reliability of selective pulmonary arteriography in the diagnosis of pulmonary embolism.
To test the reliability of conventional selective pulmonary arteriography in the diagnosis of pulmonary embolism, three angiographers reviewed the arteriograms of a series of 60 patients retrospectively, independently, and without benefit of additional data. Pulmonary arteriograms had been interpreted as positive for pulmonary embolism in 25 of these patients during their hospitalizations. Angiographers A, B, and C judged the arteriograms of 24, 29, and 25 patients, respectively, as positive for pulmonary embolism. ⋯ All angiographers agreed that the arteriograms were positive in 18 cases of pulmonary embolism graded as massive, lobar, or segmental, but agreed in only two of 15 cases graded as subsegmental. We conclude that conventional selective pulmonary arteriography is reliable in the detection of embolus in segmental or larger pulmonary arteries. Observer disagreement becomes considerable for embolus limited to subsegmental pulmonary arteries, indicating that emboli of this size are at the resolution limit of the technique.