The use of duplex ultrasonography in penetrating neck trauma

Objective: To compare intraoperative findings and/or angiography with color-flow duplex scan. Design: This prospective double-blind study was performed on all stable patients with zone 1, 2, or 3 penetrating neck trauma. Results of angiographic or intraoperative findings were compared with the results of duplex ultrasonographic scans. Main Outcome Measures: Fifty- five patients were studied over a 2-year period in which the distribution of injuries included 23 stab wounds (42%), 30 gunshot wounds (54%), and 2 motor vehicular lacerations (4%). There were 42 patients (76%) with normal ultrasonographic results and 13 patients (24%) with abnormal ultrasonographic results. The true-negative rate was 100%; however, there were 2 false positives resulting in 100% sensitivity and 85% specificity. Conclusions: Duplex ultrasonography provides an excellent diagnostic modality with cost- saving, patient-friendly characteristics and a low rate of morbidity. It should be instituted as the primary diagnostic procedure of choice for penetrating neck trauma.