Radiology
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Dynamic chest computed tomography (CT) was performed in 326 patients who had undergone abdominal CT for blunt trauma to evaluate the role of chest CT in screening for thoracic aortic injury. Evidence of mediastinal bleeding constituted an abnormal CT examination. The results were correlated with those from aortography in 131 patients. ⋯ With CT there was a significant improvement over plain radiography in specificity, accuracy, and predictive value of positive results. If chest CT were used as an adjunct to chest radiography in the screening for traumatic aortic tear, the need for aortography would decrease by 56%. Chest CT can safely help discriminate candidates for aortography, is cost-effective, and, in hemodynamically stable patients, should be incorporated in the screening for traumatic aortic tear.