Multi-detector row computed tomography: Imaging in acute aortic syndrome

Acute aortic syndromes (AAS) encompass a spectrum of emergencies. These include those non-traumatic disease entities of the aorta namely, penetrating atherosclerotic ulcer, intramural haematoma, dissection and aneurysm rupture. The various types of AAS cannot be reliably differentiated on clinical g...

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Bibliographic Details
Published in:Clinical radiology 2005-12, Vol.60 (12), p.1256-1267
Main Authors: Manghat, N.E., Morgan-Hughes, G.J., Roobottom, C.A.
Format: Article
Language:English
Subjects:
Acute Disease
Aneurysm
Aneurysm, Dissecting - diagnostic imaging
Aorta
Aortic Aneurysm - diagnostic imaging
Aortic Diseases - diagnostic imaging
Aortography - methods
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Chest pain
Computed tomography
Diagnosis, Differential
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Dissection
Electrocardiography
Humans
Medical sciences
Radiographic Image Enhancement
Radiographic Image Interpretation, Computer-Assisted
Syndrome
Tomography, X-Ray Computed - methods
Trauma
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Summary:Acute aortic syndromes (AAS) encompass a spectrum of emergencies. These include those non-traumatic disease entities of the aorta namely, penetrating atherosclerotic ulcer, intramural haematoma, dissection and aneurysm rupture. The various types of AAS cannot be reliably differentiated on clinical grounds alone. Acute thoracic aortic injury is usually included in this group even though clinical presentation is different, i.e., in the context of trauma, the imaging features are very similar. Differentiation of AAS from acute coronary syndrome (ACS) is important, however, it must be remembered that ACS may occur as a result of AAS. Now electrocardiogram (ECG)-gating technology is widely available, ECG-gated multi-detector row computed tomography (MDCT) is a powerful clinical tool in the acute emergency setting, which enables rapid and specific diagnosis of aortic pathology. ECG-gated MDCT significantly reduces motion artefact, avoids potential pitfalls in diagnosis and often provides diagnostic information about the coronary arteries. It should be used as a first-line imaging technique. This article examines the role of MDCT imaging and cardiac gating in the assessment of AAS and discusses the differentiation of this spectrum of aortic diseases with reference to the key imaging findings as obtained by experience in our institution.
ISSN:0009-9260
1365-229X
DOI:10.1016/j.crad.2005.06.011