CTICasesCalcified and Non-Calcified Atherosclerotic Plaques Mimicking Aortic Injury
Imaging findings
Thoracic spine CT of a trauma patient with a T-spine fracture shows severe, diffuse calcified and non-calcified atherosclerotic plaques. At the level of the spinal fracture, there is focal parietal thickening and irregular low-attenuation plaque along the aortic wall, with surrounding mediastinal hematoma from the adjacent vertebral fracture, mimicking a minimal aortic injury.
Key takeaways
In trauma patients with spinal fractures, adjacent mediastinal hematoma combined with focal irregular, non-calcified atherosclerotic plaque can mimic a minimal aortic injury on CT. Demonstrating that the aortic wall irregularity is stable on short-term follow-up and corresponds to diffuse plaque elsewhere helps confirm a benign, pre-existing atherosclerotic etiology rather than an acute traumatic tear.
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