Spiral CT aortography: an efficient technique for the diagnosis of traumatic aortic injury |
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Authors: | S Wicky P Capasso R Meuli A Fischer L von Segesser P Schnyder |
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Institution: | (1) Department of Radiology and Interventional Radiology, University Hospital, CHUV, CH-1011 Lausanne, Switzerland, CH;(2) Department of Cardiovascular Surgery, University Hospital, CHUV, CH-1011 Lausanne, Switzerland, CH |
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Abstract: | The objective of this study was to assess the efficiency of spiral CT (SCT) aortography for diagnosing acute aortic lesions
in blunt thoracic trauma patients. Between October 1992 and June 1997, 487 SCT scans of the chest were performed on blunt
thoracic trauma patients. To assess aortic injury, the following SCT criteria were considered: hemomediastinum, peri-aortic
hematoma, irregular aspect of the aortic wall, aortic pseudodiverticulum, intimal flap and traumatic dissection. Aortic injury
was diagnosed on 14 SCT examinations (2.9 %), five of the patients having had an additional digital aortography that confirmed
the aortic trauma. Twelve subjects underwent surgical repair of the thoracic aorta, which in all but one case confirmed the
aortic injury. Two patients died before surgery from severe brain lesions. The aortic blunt lesions were confirmed at autopsy.
According to the follow-up of the other 473 patients, we are aware of no false-negative SCT examination. Our limited series
shows a sensitivity of 100 % and specificity of 99.8 % of SCT aortography in the diagnosis of aortic injury. It is concluded
that SCT aortagraphy is an accurate diagnostic method for the assessment of aortic injury in blunt thoracic trauma patients.
Received 18 July 1997; Revision received 11 September 1997; Accepted 23 October 1997 |
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Keywords: | : Thoracic aorta Trauma Aorta rupture Spiral CT Angiography |
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