Direct findings of aortic injury on contrast-enhanced CT in surgically proven traumatic aortic injury: a multi-centre review.
OBJECTIVE
To review the contrast-enhanced CT findings in surgically proven traumatic aortic injury (TAI).


METHODS
We searched the trauma registries of three academic medical centres from 1994 to 2000 and found 34 patients with surgically proven TAI that received pre-operative contrast-enhanced chest CT. Two chest radiologists recorded by consensus the size and location of direct (pseudoaneurysm, intimal flap) and indirect (mediastinal haematoma) findings of TAI. The imaging findings were correlated with surgical reports.


RESULTS
Direct findings of aortic injury (pseudoaneurysm or intimal flap) were seen on contrast enhanced CT in all patients and confirmed at surgery. Specifically, a pseudoaneurysm was seen in 33 (97%), presenting either as a focal bulge in 22 (65%) or as more diffuse aneurysmal enlargement in 11 (32%). An intimal flap was identified in 31 cases (91%). A periaortic haematoma was seen in 31 cases (91%). In the three patients without periaortic haematoma, the only indications of aortic injury were a focal pseudoaneurysm in two (6%) and an intimal flap in one (3%).


CONCLUSIONS
In this series of surgically proven TAI, direct findings of aortic injury were seen in all cases. Aortic tear occurred without mediastinal haematoma in 9% (3/34) of patients.
Cleverley
Joanne R
JR
Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada.
Barrie
James R
JR
Raymond
Gregory S
GS
Primack
Steven L
SL
Mayo
John R
JR
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology; D001011:Aorta / Q000293:injuries*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D001027:Aortography; D003287:Contrast Media; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000209:etiology; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media