Evaluation of dissections and aneurysms of the thoracic aorta by conventional and dynamic CT scanning.
ABSTRACT Conventional computed tomography (CT) with intravenous contrast injection effectively demonstrates the features of aneurysms of the thoracic aorta (dilatation, calcification, intraluminal thrombus, and displacement and erosion of adjacent structures). In aortic dissection, CT can establish the diagnosis by demonstrating (a) double channels with an intimal flap or (b) displaced intimal calcifications if one channel is thrombosed. Dynamic CT following a contrast bolus shows the relative rate of filling of the true and false channels and demonstrates the intimal flap with optimum clarity. Reformatted CT images (paraxial and oblique) display the entire thoracic aorta in the plane of the arch, resembling an aortogram. CT is noninvasive and can be easily repeated to assess progress. Although aortography is still required prior to surgery in some cases, CT is a safe screening procedure that may avoid some invasive angiographic procedures.
- SourceAvailable from: Dan Gilon01/2000;
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ABSTRACT: For an unusual case of saccular aneurysm of the thoracic aorta in a child, the computed tomographic demonstration of a totally vascular mass led directly to the definitive diagnosis by angiocardiography and eliminated the need for many additional imaging or chemical tests. This case illustrates how computed tomography can be beneficial in the potentially difficult diagnostic evaluation of pediatric medistinal masses.CardioVascular and Interventional Radiology 02/1981; 4(1):30-32. · 1.97 Impact Factor
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ABSTRACT: Thirty-five consecutive patients with clinically suspected aortic dissection were subjected to a dual noninvasive imaging protocol using comprehensive echocardiography and ECG-triggered MRI with multi-slice spin echo and cine sequences in random order. The purpose of this dual imaging study was to compare the diagnostic accuracy of two-dimensional and color-coded Doppler echocardiography using the conventional transthoracic (TTE) and the transesophageal approach (TEE) with magnetic resonance imaging (MRI) for the exact morphologic evaluation and anatomical mapping of the thoracic aorta. The results of each diagnostic method were validated independently against the gold standard of intraoperative findings (n=17), necropsy (n=4) or contrast angiography (n=22).Compared to conventional transthoracic echocardiography both TEE and MRI were more reliable in detecting aortic dissections (TTE vs TEE: pThus, in patients with suspected acute or subacute aortic dissections the echocardiographic assessment should include the transesophageal approach for significant improvement of the moderate sensitivity and specificity of TTE. Both TEE and MRI are non-traumatic, safe and diagnostically accurate to identify and classify acute and subacute dissections of the thoracic aorta irrespective of their location. MRI provides superb anatomical mapping of all type A and B dissections and more detailed information on the site of entry and thrombus formation than TEE. These features of TEE and MRI may render retrograde contrast angiography obsolete in the setting of thoracic aortic dissection and may encourage surgical interventions exclusively on the basis of noninvasive imaging.International Journal of Cardiac Imaging 01/1994; 10(1):1-14.