Traumatic aortic injury: computerized tomographic findings at presentation and after conservative therapy.
OBJECTIVE
To determine the computerized tomographic (CT) findings in traumatic aortic injury (TAI) at presentation and after conservative management.


METHODS
Institutional review board-approved retrospective review of trauma registry during a 6-year period identified class 1 or 2 trauma patients with TAI. The CT findings were correlated with patient outcome.


RESULTS
Forty-eight of 3350 patients had TAI. Seven had TAI limited to the abdominal aorta. Twenty-nine of 48 had early (12) or delayed (17) aortic repair. Common abnormalities were pseudoaneurysms (69%) and intramural hematoma (IMH) (65%). Forty-one of 48 TAI were confirmed on endovascular imaging or surgery. Subsequent CT was available in those who had delayed repair (n = 9) or conservative management (10) and showed stable pseudoaneurysms with resolving IMH (n = 11), resolving IMH (n = 4), intimal flap (n = 2), aortic thrombus (n = 1), and dissection (n = 1).


CONCLUSIONS
Traumatic aortic injury is rare. It commonly involves thoracic aorta with pseudoaneurysm and IMH. Significant TAI in stable patients remains stable on follow-up imaging. Minor TAI may resolve with conservative therapy.
Aladham
Farid
F
Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.
Sundaram
Baskaran
B
Williams
David M
DM
Quint
Leslie E
LE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging; D017541:Aneurysm, False / Q000000981:diagnostic imaging; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000293:injuries*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging; D001027:Aortography / Q000379:methods*; D002648:Child; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed