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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
Summary
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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