Can computed tomography (CT) rule out aortic injuries?
Chest CT is considered the standard diagnostic test for suspected aortic injury because it is widely available and has extremely high sensitivity and specificity. In most cases, a negative chest CT using intravenous (IV) contrast can exclude an aortic injury. The majority of patients with complete transection or active aortic bleeding die at the scene. Patients who survive to the hospital will not have these overt findings, but they will have evidence of pseudoaneurysm or luminal disruption on CT. Pseudoaneurysm is an incomplete and highly unstable tear in the aortic wall, in which arterial blood is contained by only the adventitial layer of the aorta. Other CT signs of traumatic aortic injury include one or more of the features listed in the box below.
