Use of CT for evaluation of possible traumatic aortic injury.

Wills, John S.; Lally, James F

doi:10.2214/ajr.157.5.1927799

Cited by 6 publications

(3 citation statements)

References 2 publications

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“…Surgeons, and even some radiologists, felt that obtaining a CT scan wastes valuable time, contrast administration would interfere and confound aortography, and that arteriography would still be necessary in a substantial number of cases [11,12]. However, with the use of helical CT technology, the aorta can be evaluated directly so that confusion of mediastinal hematomas and normal structures can be avoided.…”

Section: Computed Tomographymentioning

confidence: 99%

Thoracic Vascular Trauma

Mouawad¹,

Kaoutzanis²,

Gupta³

2012

Current Concepts in General Thoracic Surgery

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Section: Computed Tomographymentioning

confidence: 99%

Thoracic Vascular Trauma

Mouawad¹,

Kaoutzanis²,

Gupta³

2012

Current Concepts in General Thoracic Surgery

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“…Unfortunately, chest radiographs are unreliable for diagnosing or excluding aortic rupture [2]. Since the introduc tion of dynamic CT, several reports have been published advocating the use of CT in excluding aortic rupture in hemodynamically stable patients; however, debate continues 28 HUNINK AND BOS AJR:165, July 1995 whether this is the optimal workup [3][4][5]. Performing CT as an initial diagnostic test before proceeding to angiography could potentially avoid many unnecessary costly and inva sive angiographic examinations.…”

mentioning

confidence: 99%

“…-Costs (in 1993 U.S. dollars) versus effectiveness (survival) for baseline analysis comparing six diagnostic strategies for diag nosing traumatic aortic rupture for hypothetical cohorts undergoing CT (^) and not undergoing CT (B) for evaluation of other injuries. AG = im mediate angiography; CT-AG = CT followed by angiography for positive cases; CXR-AG = chest radiography followed by angiography for positive cases; CXR-CT-AG -chest radiogra phy followed by CT for positive radiographic cases, followed by angiography for positive CT cases; CXR-CT = chest radiography followed by CT for positive cases; CXR only = no diagnostic workup for traumatic aortic rupture.AJR:165, July 1995 TRIAGE OF PATIENTS WITH AORTIC RUPTURE3 1…”

mentioning

confidence: 99%

Triage of patients to angiography for detection of aortic rupture after blunt chest trauma: cost-effectiveness analysis of using CT.

Hunink

Bos²

1995

American Journal of Roentgenology

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OBJECTIVE. The purpose of this study was to evaluate the costeffectiveness of dynamic chest C1 compared with plain chest radiography and immediate anglography, in deciding when angiography should be performed in hemodynamically stable patients with suspected aortic rupture after blunt chest trauma. The use of CT was evaluated in relation to the prior probability of aortic rupture. MATERIALS AND METHODS.A cost-effectiveness analysis comparing six diagnostic strategies combining chest radiography, CT, and angiography in various sequences was performed.Effectiveness was expressed as survival to hospital discharge, and costs were those incurred to socIety. Estimates for the vanables In the analysis were derived from published reports. The model was evaluated for two cohorts of patients: those undergoing and those not undergoing CT for the evaluation of other injunies. Sensitivity analysis was performed for all variables in the model with emphasis on the prior probability of aortic rupture. RESULTS. Selecting patients for triage to angiography based on the CT findings yielded higher effectiveness at a lower costeffectiveness ratio than doing so based on the chest radiograph, and the incremental cost-effectiveness ratio was less than

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Computed tomography of thoracic aortic trauma

Biquet¹,

Dondelinger²,

Roland³

1996

Eur. Radiol.

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During a 63-month period, 28 consecutive patients suspicious for injury of the thoracic aorta were examined by computed tomography (CT). Twelve aortic ruptures were evidenced; pseudoaneurysm and mediastinal haematoma in close contact with the aorta were present in 12 patients, marginal lucency in 9, marginal irregularity in 8 and intimal flap in 6. CT was falsely negative in 1 patient with injury of the left subclavian artery. Angiography and surgery confirmed the diagnosis in 7 patients, and surgery alone in 5 patients. CT had a sensitivity of 92% and a specificity of 100%. The need for angiography was obviated in 67% of patients. A radiologist with experience in trauma management, CT and angiography should perform both examinations.

show abstract

Use of CT for evaluation of possible traumatic aortic injury.

Cited by 6 publications

References 2 publications

Thoracic Vascular Trauma

Thoracic Vascular Trauma

Triage of patients to angiography for detection of aortic rupture after blunt chest trauma: cost-effectiveness analysis of using CT.

Computed tomography of thoracic aortic trauma

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