Thoracic aortic dissections: magnetic resonance imaging

Six patients with documented dissections of the thoracic aorta (two Type A, four Type B) were examined by magnetic resonance (MR) imaging using a 0.6-Tesla superconductive magnet. Cardiac gating was applied in five cases. Correlation was made with CT and angiography. MR imaging demonstrated the dissection in all six cases and accurately differentiated Type A from Type B dissections. Coronal and sagittal MR sections were advantageous in establishing the relationship of the three arch vessels to the dissection. In addition, cardiac-gated MR was useful in demonstrating mural thrombus and in distinguishing the true from the false lumen based on differences in signal intensity resulting from different flow rates. In five cases, the information obtained by MR was equal to or surpassed that obtained by CT. In the one case of a completely thrombosed dissection, the CT scan was more helpful. MR should become an important imaging modality in the evaluation of aortic dissections.