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© 2008 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 27:95-107 • 0278-4297

Image Presentation

Sonographic Evaluation of Vascular Injuries

Diana Gaitini, MD, Nira Beck Razi, MD, Eduard Ghersin, MD, Amos Ofer, MD and Michalle Soudack, MD

Department of Medical Imaging, Rambam Medical Center, Haifa, Israel.

Address correspondence to Diana Gaitini, MD, Unit of Ultrasound, Department of Medical Imaging, Rambam Medical Center, Ha’aliya 8, PO Box 9602, 31096 Haifa, Israel. E-mail: d_gaitini{at}rambam.health.gov.il

Objective. The purpose of this presentation is to highlight the color Doppler duplex sonographic features of procedure-related and blunt or penetrating trauma-related vascular injuries. Methods. Different kinds of vascular complications such as pseudoaneurysms, arteriovenous fistulas, dissection, and thrombosis are discussed. Cases of vascular injuries in the extremities, neck, and abdomen are presented to illustrate the spectrum of sonographic appearances. Results. Color Doppler duplex sonography is valuable in the diagnosis and monitoring of most vessel injuries and in the treatment of pseudoaneurysms. It is useful for flow analysis and for follow-up after treatment. However, because of limitations inherent to sonography, such as bones, air, casts, skin burns, and relatively slow performance of the test, magnetic resonance imaging, computed tomography, and angiography are necessary for further evaluation in selected cases. Conclusions. Color Doppler duplex sonography is a widely available, noninvasive, and accurate technique for evaluating vascular injuries and should be the first-line imaging modality in most patients.

Key Words: arteriovenous fistula • diagnosis • false aneurysm • sonography • vascular injuries

Abbreviations: AVF, arteriovenous fistula • CDDS, color Doppler duplex sonography • CTA, computed tomographic angiography • DSA, digital subtraction angiography • MRA, magnetic resonance angiography

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Copyright © 2008 by the American Institute of Ultrasound in Medicine.