DIAGNOSTIC-VALUE OF THE COMBINATION OF CO MPUTED-TOMOGRAPHY AND ANGIOGRAPHY IN TRAUMATIC INJURY OF THORACIC AORTA

Aim: To assess the diagnostic value of the combination of compu ted to mography and angiography in patients with blunt thoracic trauma and su spicion of aortic injury. Patients and methods: Retrospective analysis of six patients, aged 22 to 72 years old, with traumatic thoracic aor ta injury secondary to severe trauma, specially car accidents, seen be tween 1985 and 1994. Results: An early diagnosis was done in three pat ients. One patient, in whom diagnosis was delayed, died before surgery ; In three cases, CAT scan showed indirect evidence of aortic rupture, consisting in alterations of aortic outline. In other three patients, it showed hemomediastinum, associated to a left hemothorax. in one ca se. Angiography confirmed the diagnosis, localized and characterized t he injury in all patients. Conclusions: The delay in the diagnosis of aortic injury may be fatal. The combination of CAT scan and angiograph y has a high sensitivity and specificity to localize and characterize lesions of the aorta or its branches or associated organs, essential s tep for surgical planning. CAT scan restricts the use of angiography, avoiding false negative studies, but cannot be used as the sole diagno stic procedure.