Blunt traumatic aortic rupture: detection with helical CT of the chest.
OBJECTIVE
To determine the effectiveness of helical computed tomography (CT) as a screening device to detect traumatic aortic rupture.


METHODS
Helical CT was used to examine 1,518 patients with nontrivial blunt trauma. Of these patients, 127 (8.37%) with abnormal CT scans of the mediastinum or aorta underwent thoracic aortography--89 patients solely for evaluation of mediastinal hematoma depicted at CT. Imaging abnormalities were correlated with surgical or clinical outcome.


RESULTS
Twenty-one aortic injuries were identified that ranged from subtle intimal flaps to complete aortic disruption. Helical CT was more sensitive than aortography (100% versus 94.4%, respectively) but less specific (81.7% versus 96.3%, respectively) in detection of aortic injuries in patients who underwent both examinations. The association between CT findings and outcome was phi = 0.62 (chi2 = 49.1, 1 df, P < .01) and between aortography and outcome was phi = 0.85 (chi2 = 92.2, 1 df, P < .001). The P value of the difference between the phi coefficients was .10.


CONCLUSIONS
Helical CT of the chest is effective for screening critically injured patients with possible blunt thoracic aortic injuries.
Gavant
M L
ML
Department of Radiology, University of Tennessee, Memphis, USA.
Menke
P G
PG
Fabian
T
T
Flick
P A
PA
Graney
M J
MJ
Gold
R E
RE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001019:Aortic Rupture / Q000000981:diagnostic imaging*; D001027:Aortography; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging