Significance of minor blunt traumatic thoracic aortic injury based on CT images

PIAO Xuerui; YAN Zhiqiang; CHEN Ying

Abstract：Objective To investigate the definition of minor blunt traumatic thoracic aortic (BTTAI) based on CT images and its clinical significance.Methods Imaging data of 76 BTTAI patients were analyzed retrospectively.Definitions of minor TAI for this study included:1) intimal flap with or without attached thrombus;2) pseudoaneurysm ＜ 10％ of the normal aortic diameter as measured at the level of the pseudoaneurysm.Management (surgery,stent or medical treatment) and outcome/injury status at the time of the last clinical or MDCT imaging follow-up were recorded.Results 29 (38.2％) of 76 BTTAI patients were diagnosed as minor BTTAI.18 cases (62.1％) were treated with medications,8 cases (27.9％) received intervention,2 cases (6.9％) underwent open surgery,and 1 patient (3.4％) died before aortic injury management was initiated.In 22 patients who underwent MDCT follow-up,the injury was stable in 14(63.6％),improved in 4(18.2％) and resolved in 4(18.2％).In 18 patients receiving conservative treatment,14 patients underwent MDCT review,who showed no complications or progress of injury.Conclusion A suitable definition of minor BTTAI based on CT can provide a theoretical basis of reasonable and safe conservative treatment.