HELICAL CT ANGIOGRAPHY FOR TRAUMATIC AORTIC RUPTURE - CORRELATION WITH AORTOGRAPHY AND SURGERY IN 5 CASES

Dynamic computed tomography (CT) is frequently performed to assess the mediastinum in trauma patients with a suspected thoracic aortic ruptu re. Its usefulness lies in demonstrating a mediastinal hematoma. Howev er, many patients still undergo conventional aortography despite a nor mal chest CT, because of a perceived insensitivity of this technique f or diagnosing aortic rupture. One application of helical CT is CT angi ography, in which multiple thin sections are acquired through a blood vessel during the injection of iodinated contrast. Good demonstration of vascular pathology can be achieved, especially with 3-D reconstruct ions. This article reviews a series of four surgically proven thoracic aortic ruptures studied using helical CT, and one case proven to be f alse-positive by both helical CT angiography and conventional angiogra phy. Correlation between conventional and helical CT angiography was e xcellent, with similar findings and the same interpretation pitfalls. Helical CT is fast and noninvasive. Combined examination of other anat omical areas can be performed in the same procedure in major trauma pa tients. Helical CT may potentially decrease the need for aortography i n these acutely injured patients.