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Il Giornale Italiano di Radiologia Medica 2019 Maggio-Giugno;6(3):275-95

DOI: 10.23736/S2283-8376.19.00175-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

Trauma imaging: focus on epiaortic arteries injury

Vincenzo NOCE 1 , Isabella CERAVOLO 2, Giovanni BARCHETTI 2, Rosa M. AMMENDOLA 2, Margherita TRINCI 3, Fernanda ALTAVILLA 4, Riccardo FERRARI 3, Andrea LEONARDI 2, Francesco BIRASCHI 2, Michele GALLUZZO 3

1 Department of Diagnostic Imaging, European Hospital, Rome, Italy; 2 Department of Radiological Sciences, Sapienza University, Rome, Italy; 3 Division of Diagnostic Imaging, San Camillo Forlanini Hospital, Rome, Italy; 4 Department of Advanced Biomedical Sciences and Diagnostic Imaging, Federico II University, Naples, Italy


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Epiaortic vessels injuries are a rare encounter in polytrauma scenario, nonetheless they are causes of high morbidity and mortality rates. Traumatic dynamics of epiaortic vascular damage determinates different clinical scenarios, imaging findings and outcomes. An expert and well-trained radiologist should own the knowledge of imaging findings regarding epiaortic vessels injury, because arterial wall damage may be caused by both blunt trauma or penetrating injury to neck and thorax. Every polytrauma patient with severe impairment of consciousness state or complex skull-cervical spine fractures should always be adequately assessed to rule out supra-aortic arteries involvement. Computed tomography (CT) imaging plays a leading role in detecting epiaortic arteries injuries, in light of its fast acquisition time, elevated anatomical detail and excellent diagnostic performance through CT-angiographic techniques with iodinated contrast administration. The main CT findings are represented by parietal dissection, vascular stenosis or endoluminal thrombosis. MR-angiography has a limited role in emergency setting, nonetheless it is able to depict main consequences of epiaortic injuries (e.g. brain ischemia-infarction). Every radiologist who works in an emergency setting should be aware of epiaortic injury clinical characteristics with related imaging findings. In this scenario, CT-angiography is the best tool to achieve a fast and appropriate diagnosis.


KEY WORDS: Wounds and injuries; Cardiovascular system; Arteries; Blood vessels

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