Abstract
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.
MeSH terms
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Accidents, Traffic
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Adult
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Aged
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Angiography, Digital Subtraction
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Aorta, Thoracic / diagnostic imaging
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Aorta, Thoracic / injuries*
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Aorta, Thoracic / surgery
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Aortic Aneurysm, Thoracic / diagnostic imaging
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Aortic Aneurysm, Thoracic / surgery
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Aortic Rupture / diagnostic imaging
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Aortic Rupture / surgery
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False Negative Reactions
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Female
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Follow-Up Studies
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Hematoma / diagnostic imaging
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Hematoma / surgery
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Humans
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Male
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Mediastinal Diseases / diagnostic imaging
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Mediastinal Diseases / surgery
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Middle Aged
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Radiographic Image Enhancement
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Sensitivity and Specificity
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Subclavian Artery / diagnostic imaging
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Subclavian Artery / injuries
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Tomography, X-Ray Computed*
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Tunica Intima / diagnostic imaging
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Wounds, Nonpenetrating / diagnostic imaging