Paper Information

Journal:   IRANIAN JOURNAL OF RADIOLOGY   OCTOBER 2016 , Volume 13 , Number 4; Page(s) 0 To 0.
 
Paper: 

MORPHOLOGIC EVALUATION OF DUCTUS DIVERTICULUM USING MULTI - DETECTOR COMPUTED TOMOGRAPHY: COMPARISON WITH TRAUMATIC PSEUDOANEURYSM OF THE AORTIC ISTHMUS

 
 
Author(s):  ANN JUN HYUNG, YOUNG KIM EUN*, JEONG YU MI, KIM JEONG HO, KIM HYUNG SIK, CHOI HYE YOUNG
 
* DEPARTMENT OF RADIOLOGY, GACHON UNIVERSITY GIL MEDICAL CENTER, INCHEON, REPUBLIC OF KOREA
 
Abstract: 

Objectives: To evaluate morphologic variations at the aortic isthmus with particular attention to ductus diverticulum, a mimicker of traumatic pseudoaneurysm, and to describe differences using Computed Tomography (CT) images.
Patients and Methods: From December 2013 to December 2014, patients who underwent a chest CT examination after blunt trauma at our emergency department were included. Aortic isthmus morphologies were evaluated using multiplanar reconstruction (MPR) and maximum intensity projection (MIP) images as follows. Type I -concave contour, type II -convexity without a discrete bulge, or type III -a discrete focal bulge (defined as ductus diverticulum).
Results: After excluding 11 cases of traumatic pseudoaneurysm of the aortic isthmus, a total of 432 trauma patients (mean age=47.1
±19.1 years, number of males=318) were evaluated for aortic isthmus morphology, and classified as follows; type I (n=240, 55.6%), type II (n=157, 36.3%), and type III (n=35, 8.1%). As compared with traumatic pseudoaneurysm (n=11), ductus diverticulum had a smaller vertical diameter (5.5±1.3mmvs.11.2 ±2.7 mm, P<0.001), a broader base (14.9±4.1mmvs.8.8±4.5 mm, P<0.001), a smoother margin (97.1% vs.27.3%, P<0.001), and formed obtuse angle with the aortic wall. Furthermore, ductus diverticulum was not associated with the presence of a dissection flap or hemomediastinum.
Conclusion: Ductus diverticulum, a mimicker of traumatic pseudoaneurysm of the aortic isthmus, is a frequently observed anatomic variant during CT examinations. Familiarity with its CT imaging findings could avoid it being confused with traumatic pseudoaneurysm in blunt trauma patients.

 
Keyword(s): DUCTUS DIVERTICULUM, AORTA, THORACIC, TOMOGRAPHY, X-RAY COMPUTED, TRAUMA
 
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