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Thoracic aortic imaging without angiography
Insights
Computerized tomography (CT) effectively images the thoracic aorta, diagnosing dissections and aneurysms. This non-invasive method aids in evaluating mediastinal disease and related aortic pathology.
Area of Science:
- Radiology
- Cardiovascular Imaging
- Thoracic Surgery
Background:
- Angiography has traditionally been used for thoracic aorta imaging.
- Non-invasive imaging modalities are sought for evaluating mediastinal disease and aortic pathology.
Purpose of the Study:
- To evaluate the utility of computerized tomography (CT) in the initial assessment of thoracic aortic pathology.
- To determine the accuracy of CT in diagnosing conditions like aortic dissection and aneurysm.
Main Methods:
- Computerized tomography (CT) was performed on 297 patients with suspected mediastinal disease.
- Intravenous contrast material was administered to enhance visualization of the aorta and related structures.
Main Results:
- CT identified important thoracic aortic findings in 19 patients, including aortic dissection, descending thoracic aortic aneurysm, and suspected trauma.
- CT accurately diagnosed aortic dissection and aneurysm in 13 out of 15 cases.
- Distinguishing false lumen from mural thrombus in ascending aortic dissection proved challenging in two cases.
Conclusions:
- Computerized tomography (CT) is a valuable non-invasive tool for evaluating the thoracic aorta in patients with suspected mediastinal disease.
- CT demonstrates aortic pathology effectively, aiding in the diagnosis of dissections and aneurysms.
- While highly accurate, CT may have limitations in differentiating certain complex aortic pathologies.
Abstract:
Imaging of the thoracic aorta without recourse to angiography has great theoretic appeal. We have used computerized tomography (CT) in the initial evaluation of 297 patients with suspected mediastinal disease. Nineteen of this group had important findings related to the thoracic aorta: aortic dissection (six), descending thoracic aortic aneurysm (nine), suspected aortic trauma (three), and suspected false aneurysm at a coarctation repair (one). In all cases, the aorta and related pathology were readily demonstrated by CT, aided by the intravenous infusion of contrast material. In 13 of 15 cases, aortic dissection and aortic aneurysm could be accurately diagnosed. In two instances of ascending aortic dissection, it was not possible to distinguish the false lumen from mural thrombus in an atherosclerotic aneurysm.