Radiology 1999 Oct;213(1):195-202
Can chest CT be used to exclude aortic injury?
Dyer DS, Moore EE, Mestek MF, Bernstein SM, Ikle DN, Durham JD, Heinig MJ, Russ PD,
Symonds DL, Kumpe DA, Roe EJ, Honigman B, McIntyre RC Jr, Eule J Jr.
PURPOSE: To determine whether chest computed tomography (CT) can be used to exclude aortic
injury. MATERIALS AND METHODS: Patients in whom there was very high suspicion of traumatic
aortic injury were examined with aortography only. Other patients were examined with
contrast material-enhanced CT. Follow-up aortography was performed in all patients with
moderate to high suspicion of traumatic aortic injury and in all patients with CT scans
that were positive for traumatic aortic injury. CT scans were regarded as positive when
they showed mediastinal hematoma or direct findings of aortic injury. During a 4 1/2-year
period, 1,009 patients (263 female, 746 male; age range, 3-90 years) were evaluated for
possible traumatic aortic injury. RESULTS: Of the 207 patients who underwent aortography
directly without CT, 10 had traumatic aortic injury. Of the 802 patients who were examined
with CT, 382 underwent follow-up aortography. In this group, there were 10 true-positive
and no false-negative CT scans. CT had 100% sensitivity and a 100% negative predictive
value for the detection of traumatic aortic injury.
PMID: 10540662
