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Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
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Utility of four-dimensional computed tomography angiography for evaluating the mobility of a thrombus in the

Daisuke Asahara1, Toshiki Kuno2,3, Kiyoshi Koizumi4

  • 1Department of Neurology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.

Radiology Case Reports
|January 21, 2020
PubMed

Insights

Four-dimensional computed tomography angiography effectively visualized an ascending aortic thrombus causing cerebral infarction. This imaging technique enabled prompt surgery, preventing further thromboembolic events.

Area of Science:

  • Cardiovascular Imaging
  • Neurology
  • Radiology

Background:

  • Four-dimensional computed tomography (4D CT) is valuable for assessing dynamic cardiovascular structures and diagnosing related diseases.
  • Ascending aorta thrombi can lead to serious complications like cerebral infarction.
  • Transesophageal echocardiography is a standard but sometimes limited method for evaluating the ascending aorta.

Observation:

  • A case of cerebral infarction was diagnosed, originating from a thrombus within the ascending aorta.
  • The movement of this thrombus was visualized using 4D CT angiography.
  • This visualization facilitated timely surgical intervention.

Findings:

  • 4D CT angiography provides a comprehensive view of the ascending aorta, overcoming the blind spots associated with other methods.
  • The dynamic imaging capability of 4D CT angiography was crucial in understanding the thrombus's behavior.
  • Early surgical intervention was prompted by the detailed imaging provided by 4D CT angiography.

Implications:

  • 4D CT angiography serves as a rapid and effective alternative to transesophageal echocardiography for ascending aorta evaluation.
  • This imaging modality can significantly improve the diagnosis and management of cardiovascular conditions involving mobile thrombi.
  • Early detection and intervention for aortic thrombi can prevent devastating neurological events such as stroke.

Keywords:
Four-dimensional computed tomographyThrombus in the ascending aorta

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