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Blunt Traumatic Aortic Injury for the Radiologist

Discuss mechanism and patterns of BTAI

Review BTAI classification and management

Recognize post-repair normal appearance and

Mechanism: Frontal impact in MVC

Typical locations of BTAI

Aortic isthmus is most injured site

Signs on chest radiograph

Terminology: Transection versus dissection

"Transection" meaning?

SVS Classification

Intimal Tear

Intramural hematoma

SVS → Harborview Classification

MAI: Subcentimeter intimo-medial abnormality with no external contour deformity

43 M trauma transfer after ATV accident

44 M presents after MCC

38 F trauma transfer after MVC

90 F rear-ended a truck at 35 mph

31 M presents after MVC at 70 mph

Mimics: Atherosclerosis/floating thrombus

14 M presents after MVC

59 F MVC rollover, question aortic injury at OSH

Pitfall: Ductus bump

Aortic isthmus types

Ductus bump versus pseudoaneurysm

57 F presents after MVC

66 M trauma

34 F presents for follow-up after MVC

50 F trauma transfer after a 50 ft fall

21 M trauma transfer after MVC

Expected post-TEVAR findings

LSA coverage with thrombus

Bovine arch with CVA after TEVAR

Remote TEVAR with endograft infection

Other complications: Endoleak

Other complications: Stent-graft collapse

Aorta is most commonly injured at the isthmus

Morphology of BTAI directs management

Stanford MEDICINE Radiology

Description:

Learn about key imaging findings and classification systems for acute aortic injuries in this 24-minute Stanford Radiology lecture. Explore the mechanisms and patterns of Blunt Traumatic Aortic Injury (BTAI), including typical injury locations and signs on chest radiographs. Understand the SVS and Harborview classifications, and examine various case studies to recognize different types of aortic injuries. Discover potential mimics and pitfalls in diagnosis, such as atherosclerosis and the ductus bump. Gain insights into post-TEVAR (Thoracic Endovascular Aortic Repair) findings and potential complications. Enhance your ability to interpret radiological images and make informed decisions in trauma cases involving aortic injuries.

Aortic Trauma by Jody Shen, MD, Stanford Radiology

Stanford University

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