Wales L R, Morishima M S, Reay D, Johansen K
AJR Am J Roentgenol. 1982 May;138(5):821-3. doi: 10.2214/ajr.138.5.821.
Acute traumatic rupture of the thoracic aorta is an often fatal deceleration injury with only 15%--20% of victims surviving to receive emergency treatment. Numerous chest radiographic findings associated with this injury have been reported, but all are nonspecific. Nasogastric tube deviation to the right has been recently described in two series as a more sensitive and specific sign of aortic rupture, said to be present in 92.8% with rupture and in none with normal thoracic aortas. In this study of eight victims of fatal motor vehicle accidents with documented aortic rupture, five (62.5%) had nasogastric tube deviation to the right and three (37.5%) had deviation to the left. This supports other reported clinical experience suggesting that rightward nasogastric tube deviation in only 60%--70% sensitive for aortic rupture. Thus, absence of nasogastric tube deviation to the right does not exclude the diagnosis of aortic rupture, and decision-making regarding aortography must be based on other clinical and radiologic criteria.
胸主动脉急性创伤性破裂是一种常致命的减速伤，只有15%至20%的受害者能存活下来接受紧急治疗。已报告了许多与此损伤相关的胸部X线表现，但均不具特异性。最近在两个系列研究中描述了鼻胃管向右偏移是主动脉破裂更敏感且特异的征象，据称主动脉破裂患者中92.8%存在此征象，而正常胸主动脉者均无此征象。在这项针对8例有记录的主动脉破裂致命机动车事故受害者的研究中，5例（62.5%）鼻胃管向右偏移，3例（37.5%）向左偏移。这支持了其他报告的临床经验，提示鼻胃管向右偏移对主动脉破裂的敏感性仅为60%至70%。因此，鼻胃管无向右偏移并不能排除主动脉破裂的诊断，关于主动脉造影的决策必须基于其他临床和放射学标准。
