Abstract
Aortic angiography is widely considered the 'gold standard' for the diagnosis of traumatic thoracic aortic injury. Unfortunately, thoracic aortic angiography has many disadvantages: the technique is invasive but, more importantly, it is not routinely available in all hospitals, necessitating transfer of critically ill patients. Contrast-enhancement helical computerised tomography (CEHCT) of the thorax is rapidly becoming available, especially in more district general hospitals, and has been shown to be as sensitive and specific in detecting aortic trauma as angiography. This technique has the advantage of being non-invasive and is able to demonstrate injuries other than thoracic aortic disruption. We present four cases of traumatic thoracic disruption initially diagnosed using CEHCT in whom surgical repair was performed on the basis of the CEHCT findings. The surgical findings of aortic injury were correlated with CEHCT features.
Full text
PDF



Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Fertakos R. J., Schwartz J. R. Use of the Valsalva's maneuver to exclude a fixed subclavian vein stenosis. AJR Am J Roentgenol. 1996 Apr;166(4):995–995. doi: 10.2214/ajr.166.4.8610598. [DOI] [PubMed] [Google Scholar]
- Gavant M. L., Menke P. G., Fabian T., Flick P. A., Graney M. J., Gold R. E. Blunt traumatic aortic rupture: detection with helical CT of the chest. Radiology. 1995 Oct;197(1):125–133. doi: 10.1148/radiology.197.1.7568809. [DOI] [PubMed] [Google Scholar]
- Hunink M. G., Bos J. J. Triage of patients to angiography for detection of aortic rupture after blunt chest trauma: cost-effectiveness analysis of using CT. AJR Am J Roentgenol. 1995 Jul;165(1):27–36. doi: 10.2214/ajr.165.1.7785625. [DOI] [PubMed] [Google Scholar]
- Kirsh M. M., Behrendt D. M., Orringer M. B., Gago O., Gray L. A., Jr, Mills L. J., Walter J. F., Sloan H. The treatment of acute traumatic rupture of the aorta: a 10-year experience. Ann Surg. 1976 Sep;184(3):308–316. doi: 10.1097/00000658-197609000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
- PARMLEY L. F., MATTINGLY T. W., MANION W. C., JAHNKE E. J., Jr Nonpenetrating traumatic injury of the aorta. Circulation. 1958 Jun;17(6):1086–1101. doi: 10.1161/01.cir.17.6.1086. [DOI] [PubMed] [Google Scholar]
- Raptopoulos V., Sheiman R. G., Phillips D. A., Davidoff A., Silva W. E. Traumatic aortic tear: screening with chest CT. Radiology. 1992 Mar;182(3):667–673. doi: 10.1148/radiology.182.3.1535879. [DOI] [PubMed] [Google Scholar]
- Smith M. D., Cassidy J. M., Souther S., Morris E. J., Sapin P. M., Johnson S. B., Kearney P. A. Transesophageal echocardiography in the diagnosis of traumatic rupture of the aorta. N Engl J Med. 1995 Feb 9;332(6):356–362. doi: 10.1056/NEJM199502093320603. [DOI] [PubMed] [Google Scholar]
- Treasure T. Imaging the thoracic aorta in the injured patient. Heart. 1997 Sep;78(3):207–208. doi: 10.1136/hrt.78.3.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Unsworth-White M. J., Buckenham T., Treasure T. Traumatic rupture of the thoracic aorta: computed tomography may be a dangerous waste of time. Ann R Coll Surg Engl. 1994 Nov;76(6):381–383. [PMC free article] [PubMed] [Google Scholar]


