Publication Date

4-13-2026

Journal

Tomography

DOI

10.3390/tomography12040057

PMID

42042944

PMCID

PMC13120022

PubMedCentral® Posted Date

4-13-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Acute traumatic aortic injury (ATAI) is a rare but life-threatening consequence of blunt trauma that requires prompt diagnosis and accurate imaging assessment. This review presents an imaging-based approach to ATAI, with emphasis on computed tomography angiography (CTA) as the first-line modality for diagnosis, grading, treatment planning, and follow-up. CTA enables the detection of both direct and indirect signs while also allowing for the assessment of lesion severity, extent, and associated findings that may influence management. Familiarity with common mimics and anatomic variants improves diagnostic confidence and helps avoid false positive interpretations. Careful protocol optimization, including multiphasic acquisition, bolus timing, and postprocessing reconstructions, can further enhance image quality and diagnostic performance. Recognition of patient-related and technical CTA artifacts, along with strategies to reduce them, including the selective use of ECG-gated CTA, may further decrease diagnostic uncertainty. We also discuss the complementary roles of emerging CT technologies and magnetic resonance angiography in selected patients. Finally, we review current classification systems, imaging-guided management, post-treatment surveillance, and potential complications. Awareness of ATAI imaging findings, protocol optimization, and diagnostic pitfalls is essential for accurate interpretation and effective multidisciplinary care.

Keywords

Humans, Computed Tomography Angiography, Wounds, Nonpenetrating, Magnetic Resonance Angiography, Aorta, Vascular System Injuries, Acute Disease, traumatic aortic injury, imaging, computed tomography angiography

Published Open-Access

yes

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