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Vascular diseases of the thorax: evaluation with multidetector CT
Caroline Chiles1, J Jeffrey Carr
1Division of Radiological Sciences, Department of Radiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. cchiles@wfubmc.edu
Insights
Multidetector CT is now the preferred imaging method for diagnosing aortic dissection and pulmonary embolism. Future advancements may extend CT
Area of Science:
- Radiology and Medical Imaging
- Cardiovascular Diseases
- Thoracic Imaging
Background:
- Thoracic vascular diseases requiring radiologic interpretation include aortic dissection, pulmonary embolism, and coronary artery disease.
- Multidetector CT (MDCT) has significantly advanced thoracic imaging capabilities.
- Angiography was historically the gold standard for many vascular assessments.
Purpose of the Study:
- To highlight essential thoracic vascular diseases for radiologists.
- To emphasize the role of MDCT in diagnosing specific vascular conditions.
- To discuss the evolving use of CT in evaluating coronary artery disease.
Main Methods:
- Review of current literature and clinical practice regarding thoracic vascular imaging.
- Assessment of MDCT's diagnostic performance for aortic dissection and pulmonary embolism.
- Discussion of CT's potential for coronary artery disease evaluation.
Main Results:
- MDCT is the imaging modality of choice for aortic dissection and acute pulmonary embolism.
- CT offers high spatial resolution, enabling detailed visualization of thoracic vasculature.
- The transition from angiography to CT for these conditions has occurred over the past decade.
Conclusions:
- Radiologists must be proficient in interpreting CT scans for key thoracic vascular diseases.
- MDCT has become indispensable for diagnosing aortic dissection and pulmonary embolism.
- CT is poised to become a primary tool for coronary artery disease assessment in the coming years.
Abstract:
The list of vascular diseases in the thorax has been narrowed to three, which are considered essential information for radiologists interpreting CT scans of the thorax: (1) aortic dissection and its variants, intramural hematoma and penetrating atherosclerotic ulcer; (2) acute pulmonary embolism; and (3) coronary artery disease. The spatial resolution of multidetector CT is such that CT has become the imaging modality of choice for aortic dissection and pulmonary embolism. This move away from angiography has transpired over the last decade; perhaps the next decade will see the same occur for evaluation of coronary artery disease.
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