Optimising pre- and postoperative imaging for thoracic aortic pathology

Thoracic aortic pathology carries significant morbidity and mortality, which requires prompt and accurate clinical and radiological evaluation. Advances in imaging technologies have improved our knowledge of the mechanisms of growth and rupture and our understanding of endovascular repair. Computed tomography has become a crucial component in this process, replacing catheter-based angiography as the most commonly used pre- and postoperative imaging modality for the thoracic aorta. Functional imaging methods such as magnetic resonance and echocardiography are evolving and are able to provide the clinically relevant anatomic, haemodynamic and biomechanical information that is necessary for accurate diagnosis, risk stratification and selection of the appropriate treatment for an individual patient. The availability of advanced image acquisition expertise and equipment is spreading to a growing number of institutions worldwide and will greatly enhance existing imaging strategies for patients with thoracic aortic pathology.