Faculty Collaboration Database

Evaluation of traumatic aortic injury: does dynamic contrast-enhanced CT play a role? Radiology 1992 Mar;182(3):661-6

Date

03/01/1992

Pubmed ID

1535878

DOI

10.1148/radiology.182.3.1535878

Scopus ID

2-s2.0-0026544264 (requires institutional sign-in at Scopus site)   65 Citations

Abstract

To investigate the value of 5-mm contrast material-enhanced computed tomography (CT) in patients with moderate to low probability of aortic laceration after a substantial deceleration injury, scans were obtained through the upper mediastinum in 160 consecutive patients. Thoracic angiography and aortography were performed in patients with evidence of mediastinal hemorrhage at CT. There was no evidence of mediastinal hemorrhage in 132 patients with normal admission chest radiographs. In the 28 patients with abnormal admission chest radiographs, CT helped exclude mediastinal hemorrhage in 22 patients (78%), and 19 patients (68%) were treated without undergoing angiography. Six patients had mediastinal hematoma at CT. Only one had an aortic laceration at angiography. The authors conclude that 5-mm contrast-enhanced CT can help exclude mediastinal hemorrhage and reduce the angiography rate in low-to-moderate-risk patients with a widened or indeterminate mediastinum. There were no unsuspected cases of mediastinal hemorrhage in patients with normal chest radiographs. Angiography is recommended for patients considered to be at high risk for aortic laceration.

Author List

Morgan PW, Goodman LR, Aprahamian C, Foley WD, Lipchik EO

MESH terms used to index this publication - Major topics in bold

Angiography
Aorta, Thoracic
Aortic Rupture
Aortography
Hemorrhage
Humans
Mediastinal Diseases
Risk Factors
Sensitivity and Specificity
Thoracic Injuries
Tomography, X-Ray Computed
Wounds, Nonpenetrating