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Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
Published on: December 9, 2021
Experience with spiral computed tomography as the sole diagnostic method for traumatic aortic rupture
S W Downing1, J S Sperling, S E Mirvis
1Department of Surgery, University of Maryland School of Medicine, R. Adams Crowley Shock Trauma Center, Baltimore, USA. sdowing@smail.umaryland.edu
The Annals of Thoracic Surgery
|August 23, 2001
Summary
Forgoing aortography after a diagnostic spiral computed tomographic (CT) scan for aortic trauma is safe and speeds up diagnosis. This approach reduces diagnostic time for patients needing aortic repair.
Area of Science:
- Trauma Surgery
- Diagnostic Imaging
- Vascular Surgery
Background:
- Spiral computed tomographic (CT) scans are effective for screening aortic trauma.
- Aortography has been the traditional method for confirming suspected aortic injuries.
- This study investigated the safety and efficiency of omitting aortography when CT scans indicate aortic injury.
Purpose of the Study:
- To evaluate the safety and expediency of relying on spiral CT findings for aortic repair decisions.
- To compare diagnostic timelines between patients who underwent aortography and those who did not.
Main Methods:
- Retrospective review of 54 patients who underwent aortic repair between July 1994 and December 1999.
- Spiral CT was the primary diagnostic tool for 52 patients.
- Aortography was selectively used for equivocal CT results or surgeon's request.
Main Results:
- 28 patients underwent aortic repair based solely on spiral CT findings, with no unexpected operative findings.
- The mean time from admission to diagnosis was significantly shorter in the group that did not undergo aortography (1.7 hours vs. 5.7 hours).
- Both groups had a single false-positive diagnostic result.
Conclusions:
- Performing aortic repair based on diagnostic spiral CT scans is safe and efficient.
- Aortography can be reserved for cases with equivocal spiral CT findings, streamlining the diagnostic process.
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