Rol diagnóstico de la combinación tomografía computada - angiografía en lesiones traumáticas de la aorta torácica / Diagnostic role of the combination of computed tomography and angiography in traumatic injury of thoracic aorta

RESUMO

Aim: To assess tha diagnostic value of the combination of computed tomography and angiography in aptients with blunt thoracic trauma and suspicion of aortic injury. Patients and methods: restrospective analysis of six patients, aged 22 to 72 years old, with traumatic thoracic aorta injury secondary to severe trauma, specially car accidents, seen between 1985 and 1994. Results: an early diagnosis was done in 3 patients. One patient, in whom diagnosis was delayed, died before surgery. In 3 cases, CAT scan showed indirect evidence of aortic rupture, consisting in alterations of aortic outline. In other 3 patients, it showed hemomediastinum, associated to a left hemothorax in one case. Angiography confirmed the diagnosis, localized and characterized yhe injury in all patients. Conclusions: the delay in the diagnosis of aortic injury may be fatal. The combination of CAT scan and angiography has a high sensitivity and specificity to localize and characterize lesions of the aorta or its branches or associated organs, essential step for surgical planning. CAT scan restrict the use of angiography, avoiding false negative studies, but cannot be used as the sole diagnostic procedure