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Updated: May 13, 2026
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Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
Published on: December 9, 2021
Acute aortic syndromes: a second look at dual-phase CT
Andrew J Lovy1, Jessica K Rosenblum, Jeffrey M Levsky
1Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, 111 East 210th St, Gold Zone, Bronx, NY 10467, USA.
AJR. American Journal of Roentgenology
|March 26, 2013
Summary
Unenhanced CT is a valuable tool for detecting acute aortic syndromes, especially when contrast is contraindicated. However, contrast-enhanced CT angiography remains superior for comprehensive diagnosis.
Area of Science:
- Radiology
- Medical Imaging
- Cardiovascular Imaging
Background:
- Acute aortic syndromes (AAS) are life-threatening conditions requiring prompt diagnosis.
- Computed Tomography (CT) is a primary imaging modality for AAS.
- The role of unenhanced CT versus contrast-enhanced CT angiography (CTA) in AAS diagnosis is debated.
Purpose of the Study:
- To evaluate the diagnostic performance of unenhanced and contrast-enhanced CT phases for acute aortic syndromes.
- To compare the sensitivity and specificity of each CT phase in identifying different AAS subtypes.
Main Methods:
- Retrospective analysis of 2868 adult patients undergoing chest and abdomen CT for suspected AAS.
- Study population included 45 AAS patients and 45 controls.
- Review of unenhanced CT followed by contrast-enhanced CT angiography (CTA) images.
Main Results:
- Unenhanced CT demonstrated 89% sensitivity and 100% specificity for AAS.
- Unenhanced CT showed high sensitivity for type A dissection (94%) but lower for type B (71%).
- Contrast-enhanced CTA was 100% sensitive for isolated intramural hematoma.
Conclusions:
- Unenhanced CT is effective for detecting AAS, particularly for surgically treated cases.
- Unenhanced CT can serve as an initial triage tool when IV contrast is contraindicated.
- Contrast-enhanced CTA is highly sensitive for intramural hematoma, potentially reducing the need for unenhanced imaging in some cases. Optimization of imaging protocols to lower radiation dose is recommended.
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