COLOR DOPPLER SONOGRAPHY IN PENETRATING INJURIES OF THE NECK

PURPOSE: To determine whether color Doppler sonography can be a sensit ive alternative to screening arteriography for identifying arterial in jury in patients with penetrating traumatic neck injuries. METHODS: Fi fty-two patients admitted to our trauma center with penetrating neck i njuries (gunshot wounds and lacerations) were-examined prospectively w ith color Doppler sonography, and findings were compared with the resu lts of angiography (n = 44), with findings at surgery (n = 4), and wit h clinical status (n = 4). RESULTS: Color Doppler sonography correctly detected all serious injuries of the carotid arteries (n = 6; 5 diagn osed at angiography and 1 at surgery) and all injuries of the vertebra l arteries (n = 4; all diagnosed at angiography). Sonography missed 1 instance of reversible narrowing of the internal and external carotid arteries and did not show 2 normal vertebral arteries. CONCLUSION: Col or Doppler sonography was as accurate as angiography in screening clin ically stable patients with zone II or III injuries and no signs of ac tive bleeding. Our initial results suggest that in the future, sonogra phy may be used as a screening examination for arterial lesions in pat ients with penetrating neck injuries.