A comparative study on the predictive value of digital subtraction angiography and B-mode ultrasonography in evaluating arterial injury in high-voltage electrical burn of the forearm.

To compare the predictive value of digital subtraction angiography (DSA) with B-mode ultrasonography in evaluating the arterial injury in high-voltage electrical burn of the forearm, 19 forearms sustaining high-voltage electric burn were examined with DSA and B-mode ultrasonography. During surgery, the involved arteries were examined closely to compare their gross pathology with the results of DSA and B-mode ultrasonography. The thrombotic or necrotic arteries found during surgery were excised and examined pathologically. Among 19 ulnar and radial arteries examined by DSA and B-mode ultrasonography, the abnormal signs were found in 14 ulnar and 11 radial arteries in DSA, including narrowing of lumen, beading of the wall, thrombosis, and slowing of blood flow, whereas abnormal signs were shown by B-mode ultrasonography in 19 ulnar and 16 radial arteries, including roughening, edema or exfoliation of the endothelium, thickening of vessel wall, narrowing of lumen, beading of the wall, and decrease in the blood flow. The vessels with severe injuries showed thrombosis or necrosis of the vessel wall. The aforementioned changes were confirmed during surgery and pathologic examination. B-mode ultrasonography is a more efficient tool than DSA in evaluating vascular injuries of the forearm sustaining high-voltage electrical burn.

[Application of digital subtraction angiography and type B ultrasonography in the evaluation of vascular injury in patients with high voltage electrical injury].

OBJECTIVE: To compare the difference between digital subtraction angiography (DSA) and type B ultrasonography in the evaluation of vascular injury in patients inflicted with high voltage electrical injury. METHODS: Nineteen patients with high voltage electrical injury of upper limbs were enrolled in the study as burn group, and another 12 healthy volunteers as controls. The endovascular membrane, vascular wall thickness, intra-vascular blood flow and endovascular thrombosis formation of ulnar and radial arteries at wound site and in regions 5, 10 and 15 cm proximal to the wounds were examined by DSA and type B ultrasonography and compared with imagings of healthy volunteers as control. The injury degree of the ulnar and radial arteries was examined during operation for evaluation to corroborate with DSA and ultrasonography findings. Necrotic and/or thrombotic vessels were excised and sent for pathomorphological examination. RESULTS: By DSA images abnormal signs as thrombosis, vascular lumen stenosis and blood flow deceleration were found in 14 ulnar and 11 radial arteries, and the signs were more pronounced in ulnar arteries. By type B ultrasonography, abnormal signs as roughing of tunica intima, swelling or exfoliation, thickening of vascular wall, lumen stenosis, decreased blood flow, even necrosis of vascular wall and thrombosis were identified in 19 ulnar and 16 radial arteries in burn group (P < 0.05 approximately 0.01). The blood flow in ulnar artery 5 cm to the approximal part of the wound edge was obvious lower than that of the control (31.60 +/- 13.90 ml/min vs 47.70 +/- 9.60 ml/min, P < 0.05). CONCLUSION: Type B ultrasonography and DSA could be helpful in the evaluation of vascular injury in patients inflicted with high voltage electrical injury.