Background Traumatic aortic rupture (TAR) is a pathological cal entity
with a high mortality, both spontaneous and perioperative. Delayed su
rgical repair has been proposed when associated lesions are stabilized
. The aim of this study was to validate MRI for detecting both the pre
sence and type of TAR and to monitor posttraumatic aneurysm and associ
ated lesions. Methods and Results Twenty-four consecutive patients wit
h acute chest trauma and suspected aortic rupture, as suggested by eme
rgency CT or chest radiographs, were subjected to MRI and/or angiograp
hy in random order. Such parameters as the presence and type of lesion
; presence of pericardial, pericardial, mediastinal, or pleural effusi
on; and presence of associated lesions were considered in every patien
t. Follow-up imaging was performed exclusively by MRI every 1 to 2 mon
ths. TAR was present in 20 patients. No patient underwent surgery in t
he acute phase; 14 patients underwent surgery at 6.8+/-2.7 months; 5 a
re waiting for surgery; and 1 healed spontaneously. There was no overa
ll mortality. For detection of TAR, the accuracy of MRI was 100%; angi
ography, 84%; and CT, 69%. In detecting the type of lesion, the diagno
stic accuracy of MRI was 92%. During follow-up, a significant increase
in the posttraumatic aneurysm was observed in 2 patients, and surgica
l repair was initiated. Conclusions In chest trauma patients, MRI prov
ides complete anatomic data to assess the severity of aortic and thora
cic lesions. Moreover, along with the concept of delayed surgical repa
ir of TAR, MRI is the ideal modality to monitor and follow TAR before
surgical repair.