Traumatic aortic injury: diagnosis with contrast-enhanced thoracic CT--five-year experience at a major trauma center.

Mirvis, Stuart E.; Shanmuganathan, K; Miller, Ben; White, C S; Turney, Stephen Z.

doi:10.1148/radiology.200.2.8685335

Cited by 187 publications

(73 citation statements)

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“…Although some studies supported the use of CT scan in highrisk patients, many others were critical and reported poor results. In a meta-analysis of 18 studies in the Englishlanguage literature for 1983 through 1995, Mirvis et al 12 reported a sensitivity of 97.0% for aortic injury and 99.3% for mediastinal hemorrhage and a specificity of 99.8% and 87.1%, respectively. The authors suggested that all patients with a mechanism of injury suggestive of aortic injury should undergo a chest CT evaluation and supplementary angiographic evaluation should be reserved only for patients with CT findings of periaortic, middle, or superior mediastinal hemorrhage.…”

Section: Methodsmentioning

confidence: 99%

Routine Helical Computed Tomographic Evaluation of the Mediastinum in High-Risk Blunt Trauma Patients

Δημητριάδης¹

1998

Arch Surg

135

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Section: Methodsmentioning

confidence: 99%

Routine Helical Computed Tomographic Evaluation of the Mediastinum in High-Risk Blunt Trauma Patients

Δημητριάδης¹

1998

Arch Surg

135

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“…Aortography re mains the gold standard, although a role for en hanced CT has been reported [1,2]. CT is highly specificfor the detectionof traumatic aortic injuries in the presence of one or more signs of vascular injury.…”

Section: Discussionmentioning

confidence: 99%

“…CT is highly specificfor the detectionof traumatic aortic injuries in the presence of one or more signs of vascular injury. Negative CT findings have nearly a 100% negativepredictive value [1,2]. Transesophageal echocardiography or CT has beenrecommendedfor initial imaging in suspected aortic transection [1,3].…”

Section: Discussionmentioning

confidence: 99%

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Traumatic transection of a right aortic arch.

Singh

Nath²,

Soto³

et al. 1998

American Journal of Roentgenology

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“…Multidetector computed tomography (MDCT) has been shown to be accurate in noninvasively assessing these disorders [6][7][8]. The optimal CT imaging technique to be used for traumatic aortic injury and aortic dissection is still a matter of debate.…”

Section: Introductionmentioning

confidence: 99%

Comparison of retrospectively ECG-gated and nongated MDCT of the chest in an emergency setting regarding workflow, image quality, and diagnostic certainty

et al. 2005

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Purpose: This study aims to assess the influence of ECG-gated acquisition on workflow and to compare image quality and diagnostic certainty for retrospectively ECG-gated and nongated multidetector computed tomography of the chest in the emergency suite. Materials and methods: Thirty-two consecutive patients were referred for both an ECG-gated and a nongated CT to rule out traumatic thoracic injury (n=15) or acute aortic dissection (n=17). The time from the start of the transportation from the emergency suite to the CT room until the start of the CT scan was recorded. Using a scoring system, the image quality of axial images and multiplanar reformats, the presence of disease, and the subjective diagnostic certainty were assessed with regard to the vascular structures, the bone structures, and the lung parenchyma. Results: The time needed for transportation and patient preparation was 12.1±1.7 min (8.1-14.5 min). The motion artifacts of the thoracic aorta and the supra-aortic vessels were significantly reduced in the ECG-gated data acquisition compared with the nongated technique (P<0.001). Subjective diagnostic certainty for assessment of the aorta was significantly better using ECG gating. The image quality of the lung parenchyma (P<0.005), the spine (P<0.005), and the ribs (P<0.002) was inferior in the ECG-gated data sets but did not compromise the detection rate of traumatic lesions and fractures. Conclusion: Performing ECG gating in the emergency room did not slow down the diagnostic workup. ECG-gated acquisition performed better in the assessment of the aorta, but image quality for lung and bone structures was slightly reduced. Further studies are required to assess the influence of the imaging technique on the diagnostic outcome.

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Traumatic aortic injury: diagnosis with contrast-enhanced thoracic CT--five-year experience at a major trauma center.

Abstract: The CT finding of mediastinal hemorrhage alone is sensitive for traumatic aortic injury, but the finding of aortic injury is more specific.

Cited by 187 publications

References 0 publications

Routine Helical Computed Tomographic Evaluation of the Mediastinum in High-Risk Blunt Trauma Patients

Routine Helical Computed Tomographic Evaluation of the Mediastinum in High-Risk Blunt Trauma Patients

Traumatic transection of a right aortic arch.

Comparison of retrospectively ECG-gated and nongated MDCT of the chest in an emergency setting regarding workflow, image quality, and diagnostic certainty

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