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MR imaging of complications of aortic surgery
W Auffermann1, P Olofsson, R Stoney
1Department of Radiology, University of California, San Francisco 94143.
Abstract:
Sixteen patients with a variety of complications of aortic surgery were evaluated with magnetic resonance (MR) imaging. More than one complication occurred in seven patients, resulting in the following types of abnormalities: graft occlusions, two; graft infections; five; pseudoaneurysms or aneurysmal dilatation of graft anastomoses, 10; perigraft hemorrhages, four; and aortoenteric fistulas, two. The MR findings were verified by surgery in 10, by CT in four, and by angiography in 11 patients. The size and extent of pseudoaneurysm or anastomotic dilatation, the presence of thrombus and vessel occlusion, the extent of abscesses, and the effect of pseudoaneurysms and abscesses on adjacent structures were readily demonstrated by MR. The size of the residual lumen in the case of thrombosis could be assessed. Abscesses were identified by their characteristic signal increase with long repetition rates and long echo delays. Magnetic resonance was also able to exclude suspected complications such as perigraft infection, hemorrhage, and graft occlusion in four patients.
Insights
Magnetic resonance (MR) imaging effectively detects complications after aortic surgery, including graft infections and pseudoaneurysms. MR imaging also accurately excludes suspected issues, aiding in patient management.
Area of Science:
- Radiology
- Cardiovascular Imaging
- Surgical Complications
Background:
- Aortic surgery can lead to various complications.
- Accurate and timely diagnosis of these complications is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the utility of magnetic resonance (MR) imaging in diagnosing complications following aortic surgery.
- To assess the ability of MR imaging to detect and characterize specific abnormalities such as graft occlusions, infections, pseudoaneurysms, hemorrhages, and aortoenteric fistulas.
Main Methods:
- Retrospective evaluation of 16 patients with suspected aortic surgery complications using MR imaging.
- Comparison of MR findings with surgical, CT, and angiographic data for verification.
- Analysis of MR imaging characteristics for identifying specific complications like abscesses.
Main Results:
- MR imaging demonstrated various complications, including graft occlusions (2), infections (5), pseudoaneurysms/dilatation (10), hemorrhages (4), and aortoenteric fistulas (2).
- MR imaging accurately assessed the size and extent of pseudoaneurysms, graft anastomoses, thrombus, vessel occlusion, and abscesses.
- MR imaging successfully excluded suspected complications in four patients, including perigraft infection, hemorrhage, and graft occlusion.
Conclusions:
- Magnetic resonance imaging is a valuable tool for diagnosing a wide spectrum of complications after aortic surgery.
- MR imaging provides detailed anatomical information and can accurately characterize abnormalities, aiding in surgical planning and management.
- The technique is also effective in ruling out suspected complications, potentially reducing the need for further invasive investigations.