USE OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR DIAGNOSIS OF TRAUMATIC AORTIC INJURY

This prospective study was conducted to describe the signs on transeso phageal echocardiography (TEE) associated niti; traumatic aortic injur y (TAI). Twenty-eight patients with TAI underwent TEE, and they were c ompared with a control group of 30 thoracic trauma patients without ao rtic injury. The TEE signs were classified as direct or indirect signs , and the quality of imaging was assessed. Patients' TEE images were c ompared with their anatomic lesions. The direct signs were thick strip es (n=19), false aneurysm (n=7), aortic dissection (n=6), free-edge in timal flap (n=15), aortic wall hematoma (n=2), fusiform aneurysm (n=13 ), and complete aortic obstruction (n=2). The indirect signs included minor increases in aortic diameter (n=7), impairment of the aortic Dop pler color flow (n=18), and an increase of aorta-probe distance, indic ating hemomediastinum (n=23). TEE allowed diagnosis of recently descri bed Limited intimal lesions frequently missed by other conventional me thods, and permitted rapid diagnosis of complete rupture in which fast degeneration means that more time-consuming methods are not practicab le. Significant blurring of the aortic outline was noted in 20% of cas es and intraluminal artifacts were observed in 36% of cases, but neith er sign impaired accurate diagnosis of TAI. The echocardiographic sign s of aortic injury are complex and may be confined to a short section of the aorta. Therefore, examination by a physician highly trained in echocardiography is necessary in such cases.