Friday, October 5, 2012
The above images are from a patient who suffered a motor vehicle accident. The axial image demonstrates a mediastinal hematoma and an intimal flap in both the ascending and descending aorta. The sagittal image better demonstrates the continuity of the intimal flap along with aortic contour abnormality. These findings are pathognomonic for acute traumatic aortic injury.
A finding that is not demonstrated on these images is active extravasation of intravenous contrast material. Its presence would be concerning for exsanguination.
Kuhlman JE, Pozniak MA, Collins JC, et al. Radiographic and CT findings of blunt chest trauma: aortic injuries and looking beyond them. Radiographics 1998;18:1085-1106.
Steenburg SD, Ravenel JG, Ikonomidis JS, et al. Acute traumatic aortic injury: imaging evaluation and management. Radiology 2008;248:748-62.