Can chest CT be used to exclude aortic injury?
OBJECTIVE
To determine whether chest computed tomography (CT) can be used to exclude aortic injury.


METHODS
Patients in whom there was very high suspicion of traumatic aortic injury were examined with aortography only. Other patients were examined with contrast material-enhanced CT. Follow-up aortography was performed in all patients with moderate to high suspicion of traumatic aortic injury and in all patients with CT scans that were positive for traumatic aortic injury. CT scans were regarded as positive when they showed mediastinal hematoma or direct findings of aortic injury. During a 4 1/2-year period, 1,009 patients (263 female, 746 male; age range, 3-90 years) were evaluated for possible traumatic aortic injury.


RESULTS
Of the 207 patients who underwent aortography directly without CT, 10 had traumatic aortic injury. Of the 802 patients who were examined with CT, 382 underwent follow-up aortography. In this group, there were 10 true-positive and no false-negative CT scans. CT had 100% sensitivity and a 100% negative predictive value for the detection of traumatic aortic injury.
Dyer
D S
DS
Dept of Radiology, University of Colorado Health Sciences Center, Denver 80262, USA. Deb.Dyer@UCHSC.edu
Moore
E E
EE
Mestek
M F
MF
Bernstein
S M
SM
Iklé
D N
DN
Durham
J D
JD
Heinig
M J
MJ
Russ
P D
PD
Symonds
D L
DL
Kumpe
D A
DA
Roe
E J
EJ
Honigman
B
B
McIntyre
R C
RC
Eule
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000293:injuries*; D001027:Aortography / Q000191:economics; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013902:Radiography, Thoracic / Q000191:economics; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000191:economics
D003287:Contrast Media