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Acute traumatic thoracic aortic injuries: experience with 64-MDCT

Scott D Steenburg1, James G Ravenel

  • 1Department of Radiology, Medical University of South Carolina, PO Box 250322, 169 Ashley Ave., Charleston, SC 29425, USA.

AJR. American Journal of Roentgenology
|October 23, 2008
PubMed
Abstract

Insights

Sixty-four-MDCT is a fast and efficient tool for diagnosing acute traumatic aortic injury (ATAI). Direct signs of ATAI on 64-MDCT scans do not require confirmation with catheter angiography, making it potentially obsolete.

Area of Science:

  • Radiology
  • Trauma Surgery
  • Cardiovascular Imaging

Background:

  • Catheter angiography is traditionally used to confirm aortic injuries.
  • Advancements in 64-MDCT offer speed and efficiency in imaging.

Purpose of the Study:

  • To evaluate the utility of 64-MDCT in diagnosing acute traumatic aortic injury (ATAI).
  • To determine if catheter angiography is still necessary for equivocal MDCT findings.

Main Methods:

  • Retrospective review of trauma registry data from March 2005 to July 2007.
  • Correlation of 64-MDCT findings with transcatheter angiograms, surgical, and clinical reports.
  • Analysis of diagnostic accuracy, sensitivity, and specificity of 64-MDCT.

Main Results:

  • 24 patients (1.79%) had 25 aortic injuries identified by 64-MDCT.
  • 64-MDCT demonstrated high sensitivity (96.0%) and specificity (99.8%) for ATAI.
  • Catheter angiography confirmed direct MDCT signs in only 3 cases and was equivocal in 2.

Conclusions:

  • Direct signs of ATAI on 64-MDCT are reliable and do not require catheter angiography confirmation.
  • Diagnostic transcatheter angiography has limited value for clarifying equivocal or indirect MDCT findings in ATAI.

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