| Intravascular sonography in the assessment of traumatic injury of the thoracic aorta. | |
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MedLine Citation:
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PMID: 10470899 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of this study is to describe the use of intravascular sonography in the evaluation of suspected injury of the thoracic aorta as an adjunctive tool to digital subtraction arteriography (DSA). SUBJECTS AND METHODS: Images of the thoracic aorta were obtained using DSA and intravascular sonography in 20 consecutive patients who underwent arteriography after chest trauma. A 6-French, 12.5-MHz sonography catheter was used for the intravascular sonography study. Diagnoses based on the review of both studies were compared. RESULTS: Five of 20 patients had aortic or great vessel injuries confirmed by surgery. Intravascular sonographic findings were positive (one false-positive) in seven patients, whereas DSA findings were positive in six patients (one false-positive and one false-negative). Surgery showed the lesion that was false-positive using both techniques to be a ductus diverticulum. Intravascular sonographic findings included intimal flaps, intramural lesions (hematomas), pseudoaneurysms, and perivascular hematomas. CONCLUSION: In our initial limited experience, intravascular sonography of the thoracic aorta and great vessels effectively identified traumatic injuries. Intramural injury without pseudoaneurysm formation or obvious intraluminal flap was visualized by intravascular sonography in one patient but was not detected by DSA. On the other hand, a ductus diverticulum was erroneously interpreted as trauma using both techniques. Intravascular sonography is a relatively new procedure with an obvious learning curve in the interpretation of the findings. An atypical ductus diverticulum may still be mistakenly interpreted as a sign of traumatic injury of the aorta. Familiarity with intravascular sonography in the setting of aortic trauma is necessary for correct interpretation of the images. The sonographic findings offer views of the aorta that are complementary to those of aortography. |
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Authors:
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R Uflacker; J Horn; G Phillips; J B Selby |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 173 ISSN: 0361-803X ISO Abbreviation: AJR Am J Roentgenol Publication Date: 1999 Sep |
Date Detail:
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Created Date: 1999-09-21 Completed Date: 1999-09-21 Revised Date: 2008-02-15 |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 665-70 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology, Medical University of South Carolina, Charleston 29425, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Angiography, Digital Subtraction Aorta, Thoracic / injuries* Aortic Rupture / etiology, radiography, ultrasonography* Female Humans Male Prospective Studies Thoracic Injuries / complications Ultrasonography, Interventional* |
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