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Aortic dissection: a comparative study of diagnosis with spiral CT, multiplanar transesophageal echocardiography, and
T Sommer1, W Fehske, N Holzknecht
1Department of Radiology, University of Bonn, Germany.
Insights
Spiral CT and multiplanar TEE are as valuable as MR imaging for diagnosing thoracic aortic dissection. However, spiral CT is superior for assessing aortic arch vessel involvement.
Area of Science:
- Cardiovascular Imaging
- Diagnostic Radiology
Background:
- Thoracic aortic dissection is a life-threatening condition requiring accurate and timely diagnosis.
- Imaging modalities play a crucial role in evaluating the extent of dissection and involvement of arch vessels.
Purpose of the Study:
- To compare the diagnostic utility of spiral computed tomography (CT), multiplanar transesophageal echocardiography (TEE), and magnetic resonance (MR) imaging.
- To assess the effectiveness of these techniques in diagnosing thoracic aortic dissection and arch vessel involvement.
Main Methods:
- A study involving 49 patients with suspected aortic dissection.
- Utilized contrast-enhanced spiral CT, multiplanar TEE, and 0.5-T MR imaging.
- Results were validated through autopsy, intraoperative findings, angiography, and follow-up.
Main Results:
- All techniques demonstrated 100% sensitivity for detecting thoracic aortic dissection.
- Spiral CT showed superior specificity (100%) compared to TEE (94%) and MR imaging (94%).
- For arch vessel involvement, spiral CT had higher sensitivity (93%) and specificity (97%) than TEE and MR imaging.
Conclusions:
- Spiral CT, TEE, and MR imaging are equally effective for diagnosing thoracic aortic dissection.
- Spiral CT is the preferred modality for evaluating supraaortic branch involvement due to its superior performance.
Purpose:
To compare the usefulness of spiral computed tomography (CT), multiplanar transesophageal echocardiography (TEE), and magnetic resonance (MR) imaging in the diagnosis of thoracic aortic dissection and arch vessel involvement.
Materials And Methods:
Forty-nine symptomatic patients with clinically suspected aortic dissection were examined with contrast material-enhanced spiral CT, multiplanar TEE, and 0.5-T MR imaging (T1-weighted, cardiac-gated, spin-echo sequences). Imaging results were confirmed at autopsy (five patients), intraoperative exploration (23 patients), angiography (nine patients), and follow-up (12 patients).
Results:
Sensitivity in the detection of thoracic aortic dissection was 100% for all techniques. Specificity was 100%, 94%, and 94% for spiral CT, multiplanar TEE, and MR imaging, respectively. In the assessment of aortic arch vessel involvement, sensitivity was 93%, 60%, and 67%, respectively, and specificity was 97%, 85%, and 88%, respectively.
Conclusion:
Spinal CT and multiplanar TEE are as valuable as MR imaging in the detection of thoracic aortic dissection. In the assessment of the supraaortic branches, spiral CT is superior (P<.05).