A D Cook1, J S Klein, F B Rogers, T M Osler, S R Shackford. 1. Departments of Surgery and Radiology, University of Vermont College of Medicine, Fletcher Allen Health Care, 111 Colchester Ave., FL 466, Burlington, VT 05401, USA.
Abstract
BACKGROUND: The radiographic diagnosis of blunt traumatic aortic laceration (BTAL) remains problematic. We reviewed our experience with chest radiographic signs of BTAL at a single trauma center. METHODS: The chest radiographs of 188 consecutive blunt trauma patients with suspected BTAL who underwent portable chest radiography and aortography were retrospectively reviewed by a thoracic radiologist. The presence or absence of 15 radiographic findings were recorded, and the sensitivity and specificity of individual radiographic signs and combinations of signs were determined. RESULTS: There were 10 patients with BTAL. Although three signs showed greater than 90% sensitivity for BTAL, these signs showed low specificity, and no significant improvement in overall accuracy was achieved by combining radiographic findings. CONCLUSION: The experience at our institution suggests that chest radiographs have limited utility in the accurate diagnosis of blunt traumatic aortic laceration. Cross-sectional imaging techniques will likely become the preferred imaging procedures for evaluating patients with suspected BTAL.
BACKGROUND: The radiographic diagnosis of blunt traumatic aortic laceration (BTAL) remains problematic. We reviewed our experience with chest radiographic signs of BTAL at a single trauma center. METHODS: The chest radiographs of 188 consecutive blunt traumapatients with suspected BTAL who underwent portable chest radiography and aortography were retrospectively reviewed by a thoracic radiologist. The presence or absence of 15 radiographic findings were recorded, and the sensitivity and specificity of individual radiographic signs and combinations of signs were determined. RESULTS: There were 10 patients with BTAL. Although three signs showed greater than 90% sensitivity for BTAL, these signs showed low specificity, and no significant improvement in overall accuracy was achieved by combining radiographic findings. CONCLUSION: The experience at our institution suggests that chest radiographs have limited utility in the accurate diagnosis of blunt traumatic aortic laceration. Cross-sectional imaging techniques will likely become the preferred imaging procedures for evaluating patients with suspected BTAL.
Authors: Victor X Mosquera; Milagros Marini; Javier Muñiz; Vanesa Asorey-Veiga; Belen Adrio-Nazar; Ricardo Boix; José M Lopez-Perez; Gonzalo Pradas-Montilla; José J Cuenca Journal: Intensive Care Med Date: 2012-05-23 Impact factor: 17.440