title: Blunt traumatic aortic rupture: detection with helical CT of the chest.
abstract: 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.
authors.affiliation: Department of Radiology, University of Tennessee, Memphis, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Gavant
authors.forename: P G
authors.initials: PG
authors.lastname: Menke
authors.forename: T
authors.initials: T
authors.lastname: Fabian
authors.forename: P A
authors.initials: PA
authors.lastname: Flick
authors.forename: M J
authors.initials: MJ
authors.lastname: Graney
authors.forename: R E
authors.initials: RE
authors.lastname: Gold
mesh_terms: 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