Department of Cardiac Surgery, IRCCS San Martino University Hospital, Genova, Italy.
Department of Radiology, IRCCS San Martino University Hospital, Genova, Italy.
J Cardiovasc Comput Tomogr. 2015 Mar-Apr;9(2):146-8. doi: 10.1016/j.jcct.2014.10.006. Epub 2014 Oct 25.
An 18-year-old male, involved in a car accident, underwent a non-gated contrast enhanced CT with apparently no evidence of significant abnormalities of the thoracic aorta. The later onset of aortic valve regurgitation prompted a prospectively ECG-triggered high-pitch spiral acquisition using a dual-source CT system which showed a tear with a huge pseudoaneurysm of the aortic root. The patient underwent successful urgent conservative surgical repair. CT is the primary screening modality for aortic injuries. Cardiac motion artifacts may hamper sensitivity at the root/ascending aorta level when a non ECG-gated technique is used, thus masking a potentially life-threatening condition. ECG-gated-CT should be mandatorily performed in patients with a high suspicion for an aortic root trauma thus allowing timely repair and avoiding a catastrophic event.
一位 18 岁男性，遭遇车祸，进行了非门控对比增强 CT 检查，未见明显胸主动脉异常。后来出现主动脉瓣反流，提示使用双源 CT 系统行前瞻性 ECG 触发高分辨率螺旋采集，显示主动脉根部有撕裂伴巨大假性动脉瘤。患者成功接受了紧急保守手术修复。CT 是主动脉损伤的主要筛查方式。当使用非 ECG 门控技术时，心脏运动伪影可能会影响根部/升主动脉水平的敏感性，从而掩盖潜在的危及生命的情况。因此，对于高度怀疑主动脉根部创伤的患者，应强制性进行 ECG 门控 CT 检查，从而及时进行修复，避免灾难性事件发生。
