Original Research

A retrospective study of computed tomography angiography versus digital subtraction angiography in penetrating neck trauma at Groote Schuur Hospital, South Africa

Paul Scholtz, Steve Beningfield, Sally Candy
South African Journal of Radiology | Vol 18, No 1 | a601 | DOI: https://doi.org/10.4102/sajr.v18i1.601 | © 2014 Paul Scholtz, Steve Beningfield, Sally Candy | This work is licensed under CC Attribution 4.0
Submitted: 05 March 2014 | Published: 20 October 2014

About the author(s)

Paul Scholtz, Division of Radiology, Groote Schuur Hospital, Cape Town, South Africa
Steve Beningfield, Division of Radiology, Groote Schuur Hospital, Cape Town, South Africa
Sally Candy, Division of Radiology, Groote Schuur Hospital, Cape Town, South Africa


Background: Penetrating neck trauma is commonly encountered in South African trauma units, and is associated with high mortality and morbidity rates. The imaging protocol for stable patients with penetrating neck trauma remains controversial. There is only sparse data validating the use of computed tomography angiography (CTA) in the evaluation of penetrating neck trauma in South Africa.

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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Crossref Citations

1. Computed tomography angiography for aerodigestive injuries in penetrating neck trauma: A systematic review
Lorenzo Paladino, Bonny J. Baron, Gururaj Shan, Richard Sinert
Academic Emergency Medicine  vol: 28  issue: 10  first page: 1160  year: 2021  
doi: 10.1111/acem.14298