1. Can Chest CT Be Used to Exclude Aortic Injury?
- Author
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Debra S. Dyer, David L. Symonds, Marsha Heinig, Dave N. Iklé, Michael F. Mestek, David A. Kumpe, Robert C. McIntyre, Paul Russ, Ernest E. Moore, Janette D. Durham, Steven M. Bernstein, Benjamin Honigman, Edward J. Roe, and John Eule
- Subjects
Adult ,Male ,Thorax ,medicine.medical_specialty ,Aortography ,Adolescent ,Radiography ,Aortic injury ,Contrast Media ,Sensitivity and Specificity ,Predictive Value of Tests ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Child ,Aorta ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Vascular disease ,Middle Aged ,medicine.disease ,Child, Preschool ,Predictive value of tests ,Costs and Cost Analysis ,cardiovascular system ,Female ,Radiography, Thoracic ,Radiology ,Tomography ,Tomography, X-Ray Computed ,business - Abstract
To determine whether chest computed tomography (CT) can be used to exclude aortic injury.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.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.
- Published
- 1999
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