MDCT angiography of emergent, non-traumatic, upper extremity vascular lesions

Timely, accurate diagnosis of upper extremity vascular pathology is critical for successful clinical and surgical management. Although the vast majority of upper extremity vascular injury is due to trauma, physicians in the emergency setting, including radiologists, must be familiar with vascular lesions from iatrogenic injury, thromboembolic disease, vascular malformations, and vasculitis. Non-invasive diagnostic imaging with multidetector CT (MDCT) angiography is often employed in the emergency department to evaluate patients with suspected vascular pathology of the upper extremity. Maximum intensity projection and volume rendering technique are two methods that are useful for evaluating vasculature. In addition, dual-energy MDCT is useful in that it allows for the generation of iodine-selective images and bone subtracted images. These techniques can be used to create images that simulate catheter angiograms. In this article, we will discuss the role of MDCT angiography in the diagnosis and management of emergent non-traumatic vascular lesions of the upper extremity.