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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Cardiovascular magnetic resonance imaging, or CMRI, is a non-invasive diagnostic test that employs a magnetic field and radiofrequency waves to create precise images of the heart and arteries. It provides comprehensive information about cardiac anatomy, function, perfusion, and tissue characterization without ionizing radiation.IndicationsCMRI diagnoses various heart conditions, including tissue damage from heart attacks, ischemic heart disease, myocarditis, aortic issues (tears, aneurysms,...
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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Multimodality Imaging for Thoracic Aortic Aneurysms.

Henry Boyi Han1, Ghassan Elkadi2, Rafael Cires-Drouet2

  • 1Department of Internal Medicine, Division of Vascular Medicine, UT Southwestern Medical Center, 2001 Inwood Road, Dallas, TX 75390, USA; Department of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, 2001 Inwood Road, Dallas, TX 75390, USA.

Cardiology Clinics
|November 16, 2025
PubMed
Summary

Early detection of thoracic aortic disease using multimodal imaging is vital for patient outcomes. Advanced imaging parameters may improve risk assessment beyond size, but more research is needed for specific genetic conditions.

Keywords:
Aorta imagingAortic diseaseAortopathyCT angiographyEchocardiographyEhlers Danlos syndromeLoeys Dietz syndromeMarfan syndromeMultimodality imagingThoracic aortic aneurysm

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Area of Science:

  • Cardiology
  • Radiology
  • Genetics

Background:

  • Thoracic aortic disease (TAD) encompasses various conditions with significant lifelong morbidity and mortality risks.
  • Effective surveillance and complication reduction depend on early detection and multimodal imaging.

Purpose of the Study:

  • To highlight the importance of multimodal imaging in managing thoracic aortic disease.
  • To discuss emerging imaging parameters for refined risk assessment and surgical timing.
  • To identify data gaps in understanding heterogeneous TAD groups.

Main Methods:

  • Review of current literature on thoracic aortic disease imaging.
  • Analysis of traditional size criteria versus emerging imaging parameters (e.g., aortic length, indexed ratios).
  • Discussion of challenges in managing syndromic and genetic aortopathies.

Main Results:

  • Multimodal imaging and understanding disease-specific features are key to personalized TAD management.
  • Aortic length and indexed ratios show potential for improved risk stratification beyond diameter.
  • Significant data gaps persist for hereditary thoracic aortopathies and vascular Ehlers-Danlos syndrome.

Conclusions:

  • A comprehensive multimodal imaging framework is essential for optimizing patient outcomes in thoracic aortic disease.
  • Personalized management strategies require integrating advanced imaging insights.
  • Further research is needed to address specific patient populations and refine risk prediction models.