Imaging evaluation of penetrating neck injuries

Penetrating neck injuries are a significant source of morbidity and mortality. Diagnostic imaging plays an integral role in the diagnosis and management of these injuries. Although clinical management of penetrating injuries to the neck remains controversial, many institutions have shifted away from mandatory surgical exploration of most penetrating neck injuries toward use of endoscopy, various imaging modalities, and selective surgery to manage specific injuries diagnosed with these techniques. Much of this shift can be attributed to computed tomographic (CT) angiography, a fast, reliable, and noninvasive procedure that provides a global assessment of the neck, thereby reducing the frequency of nontherapeutic surgical neck explorations and limiting the need for diagnostic conventional angiography. Therefore, radiologists interpreting images from CT angiography should be prepared to provide management recommendations on the basis of the CT angiographic findings. An appreciation of the value, roles, and limitations of multidetector CT angiography and other imaging modalities can position the radiologist as a vital participant in the care of patients with penetrating trauma to the neck.