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Trauma Lower Extremity Runoff CTA

Last Updated: 2026-01-01 Author:

  • 1. Clinical Summary

    Series Phase Coverage
    CTA Arterial Arterial (bolus tracked) Coverage as needed to Distal to injury
    • Extremity vascular injury
    • Penetrating trauma
    • Fracture with vascular concern
    • Pulseless extremity

  • 2. Patient Prep

    • Position: Supine legs extended
    • NPO Status: None - trauma

  • 3. IV Contrast & Injection

    Parameter Value
    Agent Omnipaque 350
    Volume 125 mL
    Flow Rate 4-5 mL/s
    Timing Method Bolus Tracking
    ROI Placement Abdominal aorta or proximal to injury
    Trigger (HU) 150 HU

    Use full dose if GFR > 30

    If GFR < 30

    Max Contrast = \(2*\left[\frac{\text{Patient Weight}}{75 \text{ kg}} * \text{eGFR}\right]\)

  • 4. Special Notes

    • Extend coverage based on injury. Aorta to ankles if bilateral. May do unilateral focused study. Arterial phase
    • Additional Recons: MIP and 3D VR. Document vascular injury. Measure vessel caliber
    • 18-20G IV. May need proximal IV if arm injury

    Safety First

    • Renal Function: Check if available
    • Allergy: Trauma indication
    • Assess arterial injury: transection pseudoaneurysm occlusion extravasation. Evaluate fracture relationship to vessels
    • Tailor coverage to injury. Fast acquisition
Series Name Start Location End Location Delay Slice Thickness Notes
Scout Aorta or pelvis Ankles N/A N/A AP legs
CTA Arterial Coverage as needed Distal to injury Bolus tracked 0.625 mm Arterial phase runoff
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial Arterial Legs 1.5 mm/1.5 mm Vascular 3 Assess vessels
Coronal Arterial Legs 2 mm/2 mm Vascular 3 MIP overview
Sagittal Arterial Injured area 2 mm/2 mm Vascular 3 Vessel-bone relationship
3D VR Arterial Vessels 1 mm source Vascular 3 3D vascular anatomy