title: Nongated vs electrocardiography-gated CT imaging of blunt aortic root rupture in a trauma patient.
abstract: An 18-year-old male, involved in a car accident, underwent a non-gated contrast enhanced CT with apparently no evidence of significant abnormalities of the thoracic aorta. The later onset of aortic valve regurgitation prompted a prospectively ECG-triggered high-pitch spiral acquisition using a dual-source CT system which showed a tear with a huge pseudoaneurysm of the aortic root. The patient underwent successful urgent conservative surgical repair. CT is the primary screening modality for aortic injuries. Cardiac motion artifacts may hamper sensitivity at the root/ascending aorta level when a non ECG-gated technique is used, thus masking a potentially life-threatening condition. ECG-gated-CT should be mandatorily performed in patients with a high suspicion for an aortic root trauma thus allowing timely repair and avoiding a catastrophic event.
authors.affiliation: Department of Cardiac Surgery, IRCCS San Martino University Hospital, Genova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Giambuzzi
authors.affiliation: Department of Radiology, IRCCS San Martino University Hospital, Genova, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Seitun
authors.affiliation: Department of Cardiac Surgery, IRCCS San Martino University Hospital, Genova, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Salsano
authors.affiliation: Department of Cardiac Surgery, IRCCS San Martino University Hospital, Genova, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Passerone
authors.affiliation: Department of Radiology, IRCCS San Martino University Hospital, Genova, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Ferro
authors.affiliation: Department of Cardiac Surgery, IRCCS San Martino University Hospital, Genova, Italy. Electronic address: francesco.santini@univr.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Santini
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000601:surgery; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries*; D001019:Aortic Rupture / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D016638:Critical Illness; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011856:Radiographic Image Enhancement / Q000379:methods; D018570:Risk Assessment; D036542:Tomography, Spiral Computed / Q000379:methods*; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis
keywords: Aortic root injury; Aortic valve; CT; Cardiac surgery; Dissection