Traumatic Aortic Injury: Sensitivity and Specificity

Introduction: Also known as Acute Traumatic Aortic Injury, Aortic Rupture, Aortic transection. Represents injury to the aorta after trauma. In blunt trauma, typically occurs in the juxtaductal region.

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The sensitivity and specificity of findings for Traumatic Aortic Injury are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Trans-Esophageal Echocardiography	98%	100%	Study: Anesthesiology. 2000 Dec;93(6):1373-7. PMID: 11149428
CT angiography Duplicate	90%	99%	direct signs of aortic injury (e.g. contour abnormality, flap) Study: Radiology. 1996 Aug;200(2):413-22. PMID: 8685335
CT angiography Duplicate	100%	87%	mediastinal hematoma only, without direct signs of aortic injury Study: Radiology. 1996 Aug;200(2):413-22. PMID: 8685335

Specific Findings

Angiography

83%

100%

will miss minimal aortic injuries such as an intramural hematoma or limited intramural flap

Study: Anesthesiology. 2000 Dec;93(6):1373-7. PMID: 11149428

Poorly Diagnostic Findings

Widened mediastinum

53%

59%

Note that around 40% (!) of 'widened' mediastinums seen on supine radiographs will appear normal on upright views.

Study: Trauma.org http://www.trauma.org/archive/thoracic/CHESTaorta.html

Findings With Unspecified Accuracy

Finding	Sensitivity	Specificity	Comments, Study
Apical cap	No accuracy specified.		Seen on CXR Study: no study specified.
NG tube, Deviated	No accuracy specified.		Seen on CXR Study: no study specified.
Aortic nob obliteration	No accuracy specified.		Seen on CXR Study: no study specified.
Hemomediastinum	No accuracy specified.		Seen on CXR Study: no study specified.