MDCT of ductus diverticulum: 3D cinematic rendering to enhance understanding of anatomic configuration and avoid misinterpretation as traumatic aortic injury
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Acute aortic injuries are not common in the setting of severe blunt trauma, but lead to significant morbidity and mortality. High-quality MDCT with 2D MPRs and 3D rendering are essential to identify aortic trauma and distinguish anatomic variants and other forms of aortic pathology from an acute injury. Misinterpretation of mimics of acute aortic injury can lead to unnecessary arteriography and thoracic surgery. Since most traumatic injuries occur in the distal arch, radiologists must be cognizant of the range of appearances of variants related to the ductus diverticulum. Cinematic rendering (CR) is a new 3D post-processing tool that provides even greater anatomic detail than traditional volume rendering. In this case series, CR is used to impart to radiologists a better understanding of various anatomic configurations that can be seen with a ductus diverticulum.
KeywordsDuctus diverticulum 3D CT Cinematic rendering
Compliance with ethical standards
Conflict of interest
Elliot K. Fishman receives grant funding from Siemens and GE Healthcare. He is a co-founder and stockholder of HipGraphics, Inc. Pamela T. Johnson and Steven P. Rowe have no conflict of interest.
- 2.Fox N, Schwartz D, Salazar JH, Haut ER, Dahm P, Black JH, Brackenridge SC, Como JJ, Hendershot K, King DR, Maung AA, Moorman ML, Nagy K, Petrey LB, Tesoriero R, Scalea TM, Fabian TC (2015) Evaluation and management of blunt traumatic aortic injury: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg 78(1):136–146. https://doi.org/10.1097/TA.0000000000000470 CrossRefPubMedGoogle Scholar
- 3.Alkadhi H, Wildermuth S, Desbiolles L, Schertler T, Crook D, Marincek B, Boehm T (2004) Vascular emergencies of the thorax after blunt and iatrogenic trauma: multi-detector row CT and three-dimensional imaging. Radiographics 24(5):1239–1255. https://doi.org/10.1148/rg.245035728 CrossRefPubMedGoogle Scholar
- 5.Eid M, De Cecco CN, Nance JW, Jr., Caruso D, Albrecht MH, Spandorfer AJ, De Santis D, Varga-Szemes A, Schoepf UJ (2017) Cinematic rendering in CT: a novel, lifelike 3D visualization technique. AJR Am J Roentgenol 209 (2):370–379. doi: https://doi.org/10.2214/AJR.17.17850
- 7.Batra P, Bigoni B, Manning J, Aberle DR, Brown K, Hart E, Goldin J (2000) Pitfalls in the diagnosis of thoracic aortic dissection at CT angiography. Radiographics 20(2):309–320. https://doi.org/10.1148/radiographics.20.2.g00mc04309 CrossRefPubMedGoogle Scholar
- 10.Morse SS, Glickman MG, Greenwood LH, Denny DF Jr, Strauss EB, Stavens BR, Yoselevitz M (1988) Traumatic aortic rupture: false positive aortographic diagnosis due to atypical ductus diverticulum. AJR Am J Roentgenol 150 (4):793–796, DOI: https://doi.org/10.2214/ajr.150.4.793