Objectives: To assess the sensitivity and specificity of CTA versus digital subtraction angiography (DSA) in detecting arterial injury and secondarily evaluate the ability of CT to assess non-arterial injury.

Method: Using hospital and radiology databases, 23 patients were identified who had undergone both CTA and DSA for penetrating neck trauma. The data was retrospectively anonymised and randomised. A radiologist experienced in the interpretation of both trauma CTA and DSA re-reported all the imaging and the findings were compared and analysed.

Results: Twenty-four arterial injuries were detected. The sensitivity of CTA for detecting arterial injury was 78% and the specificity 83%. The ability of CTA to delineate wound track and detect non-arterial visceral injury was also confirmed.

Conclusion: CTA is an attractive initial diagnostic investigation that, along with clinical evaluation, effectively guides further investigation and intervention. It is important for the radiologist to understand the limitations of CTA and have a low threshold for DSA in equivocal cases.

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South African Journal of Radiology    |    ISSN: 1027-202X (PRINT)    |    ISSN: 2078-6778 (ONLINE)