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CT: quick and efficient in assessing traumatic injury to the abdominal aorta
Monday, 29 November 1999 19:00 | 
| Medical Conferences News - RSNA 2008 |
Abdominal aortic injury can be seen in the setting of trauma in the emergency department and CT can be used to rapidly and efficiently recognize and characterize the injury based on both direct and indirect findings, as well as catalog associated injuries.
Abdominal aortic injury can be seen in the setting of trauma in the emergency department and CT can be used to rapidly and efficiently recognize and characterize the injury based on both direct and indirect findings, as well as catalog associated injuries. That is what concludes a study by a team from the Washington University in St. Louis, presented this Sunday at the 2007 Radiological Society of North America (RSNA) annual meeting in Chicago.
The purpose of the project was to review the cases of traumatic injury to the abdominal aorta over the past five years and describe the imaging features, including common locations, direct and indirect findings. Cases included both thoracic and abdominal aortic injuries.
These were further sorted and two groups of patients were selected, one with contiguous thoracic and abdominal aortic injury, and one with distinct abdominal aortic injury. The abdominal aorta was defined to extend from the perihiatal region through the iliac vessels.
A total of 15 cases of abdominal aortic injury were found. These cases were then reviewed by three readers of varying experience and the findings summarized.
Thirty-three per cent of the patients selected had continuous thoracic and abdominal aortic injuries. The other 67 per cent had non-contiguous injuries to the abdominal aorta.
Indirect findings: retroperitoneal hematoma (67 per cent), stranding around vessels (93 per cent), hemoperitoneum (47 per cent), associated solid organ/bowel injuries (60 per cent), associated bony injuries (spine, sacrum, ribs - 93 per cent) and shock (53 per cent).
Direct findings: intramural hematoma (53 per cent), dissection flap (47 per cent), intimal injury (20 per cent), pseudoaneurysm (27 per cent), abrupt caliber change (87 per cent) and branch vessel injury (renals, IMA, lumbar - 27 per cent).
"CT is the primary detection method for abdominal aortic injury", said Meghan Lubner, MD, leader of the study. "Recognition of CT features of abdominal aortic injury is critical in making the diagnosis and guiding triage and management of the patient.
The purpose of the project was to review the cases of traumatic injury to the abdominal aorta over the past five years and describe the imaging features, including common locations, direct and indirect findings. Cases included both thoracic and abdominal aortic injuries.
These were further sorted and two groups of patients were selected, one with contiguous thoracic and abdominal aortic injury, and one with distinct abdominal aortic injury. The abdominal aorta was defined to extend from the perihiatal region through the iliac vessels.
A total of 15 cases of abdominal aortic injury were found. These cases were then reviewed by three readers of varying experience and the findings summarized.
Thirty-three per cent of the patients selected had continuous thoracic and abdominal aortic injuries. The other 67 per cent had non-contiguous injuries to the abdominal aorta.
Indirect findings: retroperitoneal hematoma (67 per cent), stranding around vessels (93 per cent), hemoperitoneum (47 per cent), associated solid organ/bowel injuries (60 per cent), associated bony injuries (spine, sacrum, ribs - 93 per cent) and shock (53 per cent).
Direct findings: intramural hematoma (53 per cent), dissection flap (47 per cent), intimal injury (20 per cent), pseudoaneurysm (27 per cent), abrupt caliber change (87 per cent) and branch vessel injury (renals, IMA, lumbar - 27 per cent).
"CT is the primary detection method for abdominal aortic injury", said Meghan Lubner, MD, leader of the study. "Recognition of CT features of abdominal aortic injury is critical in making the diagnosis and guiding triage and management of the patient.
