1. Blunt traumatic aortic rupture: detection with helical CT of the chest
- Author
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Pamela A. Flick, Timothy C. Fabian, P G Menke, Robert Gold, Morris L. Gavant, and Marshall J. Graney
- Subjects
Adult ,Male ,Traumatic aortic rupture ,Thorax ,medicine.medical_specialty ,Aortography ,Adolescent ,Aortic Rupture ,Guidelines as Topic ,Wounds, Nonpenetrating ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aortic rupture ,Aged ,Aged, 80 and over ,Aorta ,medicine.diagnostic_test ,Vascular disease ,business.industry ,Mediastinum ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Blunt trauma ,Female ,Radiography, Thoracic ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
To determine the effectiveness of helical computed tomography (CT) as a screening device to detect traumatic aortic rupture.Helical CT was used to examine 1,518 patients with nontrivial blunt trauma. Of these patients, 127 (8.37%) with abnormal CT scans of the mediastinum or aorta underwent thoracic aortography--89 patients solely for evaluation of mediastinal hematoma depicted at CT. Imaging abnormalities were correlated with surgical or clinical outcome.Twenty-one aortic injuries were identified that ranged from subtle intimal flaps to complete aortic disruption. Helical CT was more sensitive than aortography (100% versus 94.4%, respectively) but less specific (81.7% versus 96.3%, respectively) in detection of aortic injuries in patients who underwent both examinations. The association between CT findings and outcome was phi = 0.62 (chi2 = 49.1, 1 df, P.01) and between aortography and outcome was phi = 0.85 (chi2 = 92.2, 1 df, P.001). The P value of the difference between the phi coefficients was .10.Helical CT of the chest is effective for screening critically injured patients with possible blunt thoracic aortic injuries.
- Published
- 1995
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