Case report: traumatic aortic rupture: demonstration by magnetic resonance imaging.
Traumatic rupture of the aorta is a major cause of morbidity and mortality in rapid deceleration road traffic accidents, with an immediate mortality of 85%. Of the 15% that survive the initial injury, approximately 50% will die within 24 h if left untreated. Prompt diagnosis and early surgical treatment are necessary if such patients are to survive. Aortography is the standard investigation of choice and provides a rapid, sensitive test of aortic rupture. Other modalities, such as plain chest radiography, computed tomography (CT) and ultrasound may also play a role in diagnosis. Magnetic resonance imaging (MRI), with its multi-planar imaging capability, is now widely used for imaging non-traumatic disorders of the aorta. However, its use in traumatic rupture has been limited by difficulties in monitoring and in access to the patient during the scan. We present a patient who survived the initial injury, when the diagnosis of aortic rupture was not suspected. and presented 3 weeks later with chest pain. An MRI scan was feasible as the patient was haemodynamically stable, and it provided an elegant non-invasive means of diagnosis, so that aortography was not necessary in this case. Although aortography is likely to remain the investigation of choice in the acute situation, MRI is a useful alternative in selected cases.
Hughes
J P
JP
Department of Radiology, University Hospital of Wales, Cardiff, South Glamorgan, UK.
Ruttley
M S
MS
Musumeci
F
F
D000063:Accidents, Traffic; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis*; D001019:Aortic Rupture / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed