SPIRAL CT AORTOGRAPHY - AN EFFICIENT TECHNIQUE FOR THE DIAGNOSIS OF TRAUMATIC AORTIC INJURY

The objective of this study was to assess the efficiency of spiral CT (SCT) aortography for diagnosing acute aortic lesions in blunt thoraci c trauma patients. Between October 1992 and June 1997, 487 SCT scans o f the chest were performed on blunt thoracic trauma patients. To asses s aortic injury, the following SCT criteria were considered: hemomedia stinum, peri-aortic hematoma, irregular aspect of the aortic wall, aor tic pseudodiverticulum, intimal flap and traumatic dissection. Aortic injury was diagnosed on 14 SCT examinations (2.9 %), five of the patie nts having had an additional digital aortography that confirmed the ao rtic trauma. Twelve subjects underwent surgical repair of the thoracic aorta, which in all but one case confirmed the aortic injury. Two pat ients died before surgery from severe brain lesions. The aortic blunt lesions were confirmed at autopsy. According to the follow-up of the o ther 473 patients, we are aware of no false-negative SCT examination. Our Limited series shows a sensitivity of 100% and specificity of 99.8 % of SCT aortography in the diagnosis of aortic injury. It is conclud ed that SCT aortagraphy is an accurate diagnostic method for the asses sment of aortic injury in blunt thoracic trauma patients.