{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:13:10Z","timestamp":1776085990901,"version":"3.50.1"},"reference-count":73,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/tomography12040057","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T11:38:26Z","timestamp":1776080306000},"page":"57","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Traumatic Aortic Injury: What the Radiologist Needs to Know"],"prefix":"10.3390","volume":"12","author":[{"given":"Kristina","family":"Ramirez-Garcia","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3934-6650","authenticated-orcid":false,"given":"Catalina","family":"Jaramillo","sequence":"additional","affiliation":[{"name":"Department of Radiology and Diagnostic Imaging, Ochsner Health, New Orleans, LA 70121, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Au","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika","family":"Odisio","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo S.","family":"Oderich","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Ocazionez","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cihan","family":"Duran","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanila","family":"Macedo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMra0706159","article-title":"Blunt Aortic Injury","volume":"359","author":"Neschis","year":"2008","journal-title":"N. 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