Color Doppler sonography in penetrating injuries of the neck

PURPOSE: To determine whether color Doppler sonography can be a sensitive alternative to screening arteriography for identifying arterial injury in patients with penetrating traumatic neck injuries. METHODS: Fifty-two patients admitted to our trauma center with penetrating neck injuries (gunshot wounds and lacerations) were examined prospectively with color Doppler sonography, and findings were compared with the results of angiography (n = 44), with findings at surgery (n = 4), and with clinical status (n = 4). RESULTS: Color Doppler sonography correctly detected all serious injuries of the carotid arteries (n = 6; 5 diagnosed at angiography and 1 at surgery) and all injuries of the vertebral 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: Color Doppler sonography was as accurate as angiography in screening clinically stable patients with zone II or III injuries and no signs of active bleeding. Our initial results suggest that in the future, sonography may be used as a screening examination for arterial lesions in patients with penetrating neck injuries.