Major CT imaging features of solid organ traumatic injury

Major CT imaging features of solid organ traumatic injury

Contusions, lacerations, infarction, arterial pseudoaneurysm formation, and acute hemorrhage/hematomas with or without active bleeding are findings that may be encountered on CT in the setting of solid organ injury. Contusions usually appear as focal regions of hypoattenuation. Lacerations appear as irregular linear, curvilinear, or branching foci of hypoattenuation within the parenchyma of a solid organ, sometimes containing gas or high attenuation hemorrhage. When lacerations are severe, portions of organ parenchyma may even avulse from the remainder of the organ. Parenchymal infarctions typically appear as focal or diffuse areas of hypoattenuation owing to lack of enhancement, often peripheral in location and wedge-shaped when focal, and commonly with a preserved peripheral rim of enhancement resulting from capsular collateral vascular supply. Arterial pseudoaneurysms generally appear as focal, round, or oval well-circumscribed structures that enhance in the arterial phase and then wash out in the venous or delayed phase to a degree similar to that of other arterial vessels. Presence of active hemorrhage or of vascular injuries on CT are generally predictive of the need for angiography and transcatheter embolization or surgery.


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