Colour-flow ultrasound in the detection of penetrating vascular injuries of the neck

Purpose. To determine the sensitivity of colour-flow ultrasound in the dete ction of penetrating vascular injuries of the neck when compared with conve ntional angiography. Method. We prospectively imaged the neck arteries of all patients with susp ected vascular injuries who were referred for angiography by the vascular s urgeon over a 6-month period. All sonograms were performed by the same radi ologist before angiography using a 7.5 or 10 MHz transducer on the same sca nner. Data recorded were the presence or absence of vascular injury, the si te of injury and the type (intimal, dissection, false aneurysm or fistula). Angiography was performed immediately afterwards by a different radiologis t. Results were correlated with the angiogram and operative findings. Results. 25 patients were studied. 15 patients had normal ultrasound studies and an giograms. Ultrasound studies were positive in 10 patients (40%), with false aneurysms and arteriovenous fistulas detected in 8 patients; these were co nfirmed on angiography and at operation. There were intimal injuries in 2 p atients (4%) that were undetected on angiography but confirmed at surgery. There were no false-positive or false-negative ultrasound studies. Conclusion. Colour-now ultrasound is sensitive in detecting vascular injuri es and is suitable as a screening investigation in patients with penetratin g neck injuries.