Wicky S, Capasso P, Meuli R, Fischer A, von Segesser L, Schnyder P
Department of Radiology and Interventional Radiology, University Hospital, CHUV, CH-1011 Lausanne, Switzerland.
Eur Radiol. 1998;8(5):828-33. doi: 10.1007/s003300050480.
The objective of this study was to assess the efficiency of spiral CT (SCT) aortography for diagnosing acute aortic lesions in blunt thoracic trauma patients. Between October 1992 and June 1997, 487 SCT scans of the chest were performed on blunt thoracic trauma patients. To assess aortic injury, the following SCT criteria were considered: hemomediastinum, peri-aortic hematoma, irregular aspect of the aortic wall, aortic pseudodiverticulum, intimal flap and traumatic dissection. Aortic injury was diagnosed on 14 SCT examinations (2.9 %), five of the patients having had an additional digital aortography that confirmed the aortic trauma. Twelve subjects underwent surgical repair of the thoracic aorta, which in all but one case confirmed the aortic injury. Two patients died before surgery from severe brain lesions. The aortic blunt lesions were confirmed at autopsy. According to the follow-up of the other 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 concluded that SCT aortagraphy is an accurate diagnostic method for the assessment of aortic injury in blunt thoracic trauma patients.
本研究的目的是评估螺旋CT（SCT）主动脉造影对诊断钝性胸部创伤患者急性主动脉病变的有效性。1992年10月至1997年6月期间，对钝性胸部创伤患者进行了487次胸部SCT扫描。为评估主动脉损伤，考虑了以下SCT标准：纵隔积血、主动脉周围血肿、主动脉壁不规则、主动脉假性憩室、内膜瓣和创伤性夹层。14次SCT检查诊断为主动脉损伤（2.9%），其中5例患者还进行了数字主动脉造影，证实了主动脉创伤。12例患者接受了胸主动脉手术修复，除1例病例外，所有病例均证实了主动脉损伤。2例患者术前因严重脑损伤死亡。主动脉钝性病变在尸检时得到证实。根据对其他473例患者的随访，我们未发现SCT检查有假阴性。我们的有限系列研究显示，SCT主动脉造影诊断主动脉损伤的敏感性为100%，特异性为99.8%。结论是，SCT主动脉造影是评估钝性胸部创伤患者主动脉损伤的一种准确诊断方法。
