Aortic Injury and Hemopericardium: Key Findings and Evaluation.

Traumatic thoracic aortic injury and hemopericardium are among the most life-threatening conditions encountered in acute thoracic trauma care. CT angiography (CTA) is the cornerstone of evaluation in such cases, providing essential information for diagnosis, triage, and treatment planning. In traumatic aortic injury, key CTA findings, including the presence of an intimal flap, intramural hematoma, pseudoaneurysm, and contrast extravasation, form the basis of the Society for Vascular Surgery grading system and guide management. In patients with traumatic hemopericardium, CT attenuation characteristics, imaging features of cardiac tamponade, and associated cardiac injuries help determine the urgency and approach to intervention. Familiarity with common pitfalls and mimickers, including ductus diverticulum, mediastinal hematoma without aortic injury, and motion-related artifacts, is essential to avoid diagnostic errors. Structured reporting can facilitate communication of management-relevant findings and support timely decision-making. This review summarizes the imaging findings, grading systems, management implications, pitfalls, and structured reporting considerations for traumatic aortic injury and hemopericardium.