CTICasesMinimal Traumatic Aortic Injury
Imaging findings
Trauma CT in a 40-year-old woman post high-speed motor vehicle crash shows a small, rounded filling defect in the proximal descending aorta just distal to the aortic isthmus, measuring less than 10 millimeters, representing a minimal intimal tear. Two other tiny, similar minimal aortic injuries are present lower down near the diaphragm. Follow-up CT performed two days later demonstrates regression of the proximal defect and complete healing of the two distal lesions.
Key takeaways
Minimal traumatic aortic injuries are characterized by small intimal tears or flaps (filling defects less than 10 millimeters) without associated mediastinal hematoma or pseudoaneurysm. With the high resolution of modern multi-detector CT, these subtle vascular injuries are frequently detected. Most minimal injuries are stable and heal spontaneously under conservative medical management, avoiding surgical or endovascular intervention.
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