Radiology · Emergency and Trauma Radiology (FAST, Polytrauma CT, Imaging in ATLS)

On a focused CT chest performed after blunt thoracic trauma, a 'bloody crescent' sign is noted posterior to the aortic arch. What does this sign indicate?

  • A Aortic intramural haematoma
  • B Traumatic aortic transection
  • C Haemopericardium
  • D Pulmonary contusion
Correct answer: A. Aortic intramural haematoma

Explanation

The 'crescent sign' in CT refers to a high-attenuation crescent of blood within the aortic wall representing intramural haematoma, an acute aortic syndrome. Traumatic aortic transection typically shows periaortic haematoma and aortic contour irregularity. Haemopericardium shows fluid around the heart, and pulmonary contusion is parenchymal opacification.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

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