Üst ekstremite arteriyel ekstravazasyon BT bulguları

Özet

Üst ekstremite travmatik arter yaralanmaları BTA’da kontrast ekstravazasyonu veya havuzlanması şeklinde görülebilir. Üst ekstremite travmasında BT anjiyografi, aksiller ve brakiyal arter düzeyinde damar dışı aktif kontrast extravazasyonu ve arterle bağlantılı psödoanevrizma gibi doğrudan arteriyal yaralanma bulgularını gösterir. Üst ekstremite BTA’da yaralanmanın yeri ve defekt uzunluğu ile eşlik eden kemik ve yumuşak doku yaralanmaları değerlendirilir. Üst ekstremite BTA’da artefaktlar damar anormalliklerini taklit edebilir veya maskeleyebilir.

Faz ve pencere

BTA tanısal: Üst ekstremite BTA’da travmatik arter yaralanması kontrast ekstravazasyonu veya havuzlanması şeklinde görülebilir; eşlik eden yumuşak doku yaralanmaları da değerlendirilir.
Gecikmiş tanısal: Üst ekstremite travmatik arter yaralanmalarında BTA’da kontrast ekstravazasyonu veya havuzlanması ve psödoanevrizma doğrudan bulgular arasında yer alır.
Kontrastsız: Travma veya ameliyat sahasında metal, kemik fragmanı, klips ya da önceden verilmiş embolik materyalin doğal yüksek atenüasyonunu kontrast kaçağından ayırmaya yardımcı olur; tek başına aktif ekstravazasyonu göstermez.

Önerilen pencereler: Anjiyo (G 600 / M 150), Yumuşak doku (G 400 / M 40), Kemik (G 1800 / M 400).

BT bulguları

Üst ekstremite travmatik arter yaralanmalarında BTA’da kontrast ekstravazasyonu veya havuzlanması doğrudan bulgulardandır.
Üst ekstremite BTA’da arteriyel bulguların yanı sıra eşlik eden yumuşak doku yaralanmaları da değerlendirilir.
Genişleyen hematom — takip görüntülerinde hematomun büyümesi kanama açısından şüphe uyandırabilir; aktif arteriyel ekstravazasyon ise üst ekstremite BTA’da doğrudan arter yaralanması bulgularındandır.
Eşlik eden arter kesintisi — aynı seviyede kısa veya uzun segment opasifikasyon kaybı, ekstravazasyonla birlikte transeksiyon ya da tromboz gösterebilir.
Yaralanma yolu — mermi izi, yumuşak doku gazı, yabancı cisim veya kırık fragmanının arterle kesişmesi olası kanama kaynağını belirler.
Hematomun kompartıman ilişkisi — kol veya önkol kas kompartımanlarına uzanan kanın dağılımı ve damar-nörovasküler demetle ilişkisi tarif edilir.

Normalde

Şüpheli arteriyel bulguları değerlendirirken normal üst ekstremite arter anatomisi bilinmelidir. Üst ekstremite BTA yorumunda damar açıklığı ve düzensizliği değerlendirilir.

Ayırıcı tanı

Psödoanevrizma, üst ekstremite travmasında BTA’da saptanabilen doğrudan arter yaralanması bulgularındandır.
Üst ekstremite arter yaralanmasına eşlik eden venöz yaralanmalar da görülebilir.
Önceden mevcut metal veya embolik materyal: kontrastsız görüntüde de yüksek atenüasyonlu olarak bulunur ve takip serilerinde boyut değiştirmez.
Arter açıklığı ve düzensizliği BTA’da değerlendirilir.

Tuzaklar

Tek arteriyel seride sabit sınırlı psödoanevrizma ile aktif kaçak benzer görünebilir; mümkünse aynı odağın gecikmiş görüntüde biçim ve yayılım değişimini karşılaştırın.
Üst ekstremite BTA’da artefaktlar damar anormalliklerini taklit edebilir veya maskeleyebilir; bulgular yorumlanırken artefakt olasılığı dikkate alınmalıdır.
Mermi fragmanı veya ameliyat klipsi kontrast odağına benzeyebilir; kontrastsız edinimde mevcut olup olmadığını ve metal çizgilenmesinin çevre dokulara uzanmasını kontrol edin.
Küçük arter yaralanması metal artefaktı altında saklanabilir; damar devamlılığını artefaktın proksimal ve distalinde ayrı ayrı izleyin ve raporda değerlendirilemeyen aralığı belirtin.

Kendini dene

Penetran kol yaralanmasında BTA’da arteriyel kontrast ekstravazasyonu görülüyor. En olası tanı nedir?
Cevabı göster
Aktif arter kanaması. BTA’da kontrast ekstravazasyonu, travmatik arteriyel yaralanmanın doğrudan bulgularındandır. Üst ekstremite travmatik arter yaralanmasının BTA bulguları arasında psödoanevrizma, lümen daralması ve dolum defekti de bulunur.
Üst ekstremite travmatik arter yaralanmalarında BTA’da doğrudan bulgu olarak hangisi görülebilir?
Cevabı göster
Psödoanevrizma. Psödoanevrizma, üst ekstremite travmatik arter yaralanmalarında BTA’da görülebilen doğrudan bulgulardandır.

İlgili konular

Kaynaklar

Bu sayfadaki 34 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 18 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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