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CT aortography of thoracic aortic rupture
1Department of Radiology, University of Tennessee, Memphis College of Medicine, TN, USA.
AJR. American Journal of Roentgenology
|April 1, 1996
Summary
Helical CT angiography can replace transcatheter aortography for diagnosing thoracic aortic injuries in critically injured patients, though axial images are crucial for smaller tears.
Area of Science:
- Radiology
- Trauma Surgery
- Cardiovascular Imaging
Background:
- Thoracic aortic rupture is a life-threatening injury often diagnosed with CT screening.
- Emergent aortography is the standard for confirming suspected aortic injuries.
- Transcatheter aortography is invasive and may not be suitable for all critically injured patients.
Purpose of the Study:
- To evaluate the efficacy of helical CT aortography as a replacement for transcatheter aortography in critically injured patients with suspected thoracic aortic rupture.
Main Methods:
- A prospective study of 3229 patients with blunt chest trauma over 22 months.
- Helical CT screening was performed, followed by advanced 2D and 3D image reconstructions.
- Stable patients underwent transcatheter aortography or surgery for definitive diagnosis and management.
Main Results:
- 38 thoracic aorta and great vessel injuries were detected.
- Helical CT angiography identified tears over 15 mm effectively.
- Axial CT images were essential for detecting smaller tears (<15 mm) and indeterminate findings.
Conclusions:
- Axial helical CT is a reliable method for detecting and defining thoracic aortic injuries.
- CT angiography can supplement conventional imaging and potentially replace transcatheter aortography in many cases.
- Transcatheter aortography remains necessary for small tears or equivocal CT studies.