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Imaging and Surveillance of Chronic Aortic Dissection: Current Practice and Future Directions

Samad A Raza1, Abid Khan2, Aman B Williams3

  • 1Department of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Qld, Australia.

Heart, Lung & Circulation
|March 14, 2025
PubMed

Insights

Chronic aortic dissection requires advanced imaging for monitoring. Emerging techniques like 4D MRI and CFD show promise for predicting complications and guiding early intervention in patients with aortic dissection.

Area of Science:

  • Cardiovascular Imaging
  • Medical Diagnostics
  • Radiology

Background:

  • Chronic aortic dissection presents a complex and varied clinical course.
  • Long-term surveillance is crucial for identifying intervention candidates and monitoring post-surgical patients.
  • Current imaging methods like CT and MRI have limitations in predicting late complications.

Purpose of the Study:

  • To analyze current diagnostic and surveillance imaging modalities for chronic aortic dissection.
  • To explore emerging imaging techniques for improved prognostication and early intervention.
  • To discuss future directions in aortic imaging for high-risk patients.

Main Methods:

  • Review of current computed tomography (CT) and magnetic resonance imaging (MRI) techniques.
  • Analysis of emerging modalities including four-dimensional MRI (4D MRI) and computational fluid dynamics (CFD).
  • Evaluation of hemodynamic variables for prognostic value.

Main Results:

  • CT and MRI provide detailed anatomical information but cannot accurately predict late complications.
  • 4D MRI and CFD identify hemodynamic variables with potential prognostic value for adverse events.
  • These emerging techniques may be integrated into routine clinical practice for better risk stratification.

Conclusions:

  • Advanced imaging is essential for managing chronic aortic dissection.
  • Emerging hemodynamic assessments offer potential for improved prediction of rupture, malperfusion, and degeneration.
  • Future imaging paradigms aim to enhance prognostication and facilitate earlier intervention in high-risk patients.

Keywords:
4D-MRIAortic dissectionComputed tomography: Magnetic resonance imagingEndovascular surgery

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