Diagnostic value of multislice computerized tomography angiography for aortic dissection: A comparison with DSA

Area of Science:

• Cardiovascular Imaging
• Radiology
• Vascular Surgery

Background:

• Aortic dissection diagnosis requires precise imaging for effective treatment planning.
• Multislice computed tomography angiography (MSCTA) and digital subtraction angiography (DSA) are key diagnostic modalities.
• Optimizing 3D reconstruction techniques in MSCTA is crucial for accurate assessment.

Purpose of the Study:

• To compare the diagnostic accuracy of MSCTA and DSA in identifying aortic dissection.
• To evaluate the effectiveness of different 3D reconstruction methods (VR, MIP, MPR, CPR) in MSCTA.
• To assess MSCTA's utility in preoperative planning for endovascular stent-graft repair.

Main Methods:

• 49 patients with aortic lesions underwent enhanced MSCTA with 3D image reconstruction.
• Reconstruction methods included Volume Rendering (VR), Maximum Intensity Projection (MIP), Multiplanar Reformation (MPR), and Curved Planar Reconstruction (CPR).
• For 30 DeBakey type III dissections, specific measurements were taken, and MSCTA data was compared with DSA.

Main Results:

• MPR and CPR demonstrated the highest display rates (95.92%) for the entry tear site, followed by VR (18.37%).
• All three methods (MPR, CPR, VR) achieved 100% display rate for the intimal flap; MIP was ineffective for these features.
• MSCTA showed significant differences in entry site display compared to DSA (P<0.05), but lumen diameter measurements were comparable (P>0.05).

Conclusions:

• MPR and CPR are the optimal 3D reconstruction methods for MSCTA in diagnosing aortic dissection.
• MSCTA, particularly with MPR and CPR, is a preferable imaging method for preoperative evaluation of aortic dissection and endovascular repair.
• MSCTA provides valuable insights for guiding endovascular-covered stent-grafting procedures.