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MDCT pp 225-235 | Cite as

MDCT Angiography of the Thoracic Aorta

  • Geoffrey D. Rubin
  • Mannudeep K. Kalra

Abstract

Multidetector computed tomography angiography (MDCTA) is a nonivasive and accurate technique for assessment of many thoracic aortic abnormalities. It offers several advantages over conventional aortography for evaluation of the thoracic aorta. State-of-the-art MDCT scanners, with improved temporal and isotropic resolution, enable volumetric acquisition that provides clear anatomic delineation of thoracic aorta, its tortuous branches, and adjacent aneurysms and pseudo aneurysms. In contrast with the projectional technique of conventional aortography, these frequently overlapping structures can affect visualization and delineation of anatomic relationships. In addition, MDCTA allows simultaneous delineation of true and false luminal flow channels in thoracic aortic dissections, intramural hematomas communicating with the aortic lumen, slow perigraft blood flow around aortic stent grafts, as well as direct visualization of the aortic wall and noncommunicating intramural hematomas. This chapter reviews techniques for acquisition and interpretation of thoracic aortic MDCTA and describes abnormalities in which MDCTA provides valuable information.

Keywords

Aortic Dissection Thoracic Aorta Volume Rendering False Lumen Intramural Hematoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Lembcke A, Dohmen P, Rodenwaldt J et al (2003) Images in cardiovascular medicine. Recoarctation of the aorta associated with ascending aortic aneurysm demonstrated by ECG-gated multislice CT. Circulation. 107:e80–81CrossRefGoogle Scholar
  2. 2.
    Marten K, Funke M, Rummeny EJ, Engelke C (2005) Electrocardiographic assistance in multidetector CT of thoracic disorders. Clin Radiol 60:8–21CrossRefPubMedGoogle Scholar
  3. 3.
    Remy-Jardin M, Remy J, Wattinne L, Giraud F (1992) Central pulmonary thromboembolism: Diagnosis with spiral volumetric CT with the single-breath-hold technique—Comparison with pulmonary angiography. Radiology 185:381–387PubMedGoogle Scholar
  4. 4.
    Rubin GD, Lane MJ, Bloch DA (1996) Optimization of contrast enhanced thoracic spiral CT. Radiology 201:785–791PubMedGoogle Scholar
  5. 5.
    Prokop M, Schaefer CM, Leppert AGA, Galanski M (1993) Spiral CT Angiography of Thoracic Aorta: Femoral or Antecubital Injection Site for Intravenous Administration of Contrast Material? Radiology 189(P):111Google Scholar
  6. 6.
    Posniak HV, Olson MC, Demos TC (1993) Aortic motion artifact simulating dissection on CT scans: elimination with reconstructive segmented images. AJR Am J Roentgenol 161:557–558PubMedGoogle Scholar
  7. 7.
    Rubin GD, Dake MD, Semba CB (1995) Current status of three-dimensional spiral CT scanning for imaging the vasculature. Radiologic Clinics of North America 33:51–70PubMedGoogle Scholar
  8. 8.
    Napel S, Rubin GD, Jeffrey RB Jr (1993) STS-MIP: A new reconstruction technique for CT of the chest. J Comput Assist Tomogr 17:832–838CrossRefPubMedGoogle Scholar
  9. 9.
    Rubin GD, Dake MD, Napel S et al (1994) Spiral CT of renal artery stenosis: comparison of three-dimensional rendering techniques. Radiology 190:181–189PubMedGoogle Scholar
  10. 10.
    Keller PJ, Drayer BP, Fram EK et al (1989) MR angiography with two-dimensional acquisition and three-dimensional display. Radiology 173:527–532PubMedGoogle Scholar
  11. 11.
    Napel S, Marks MP, Rubin GD et al (1992) CT angiography with spiral CT and maximum intensity projection. Radiology 185:607–610PubMedGoogle Scholar
  12. 12.
    Drebin RA, Carpenter L, Hanrahan P (1988) Volume rendering. Comput Graphics 22:65–74CrossRefGoogle Scholar
  13. 13.
    Levoy M (1991) Methods for improving the efficiency and versatility of volume rendering. Prog Clin Biol Res 363:473–488PubMedGoogle Scholar
  14. 14.
    Rusinek H, Mourino MR, Firooznia H et al (1989) Volumetric rendering of MR images. Radiology 171:269–272PubMedGoogle Scholar
  15. 15.
    Fishman EK, Drebin B, Magid D et al (1987) Volumetric rendering techniques: applications for three-dimensional imaging of the hip. Radiology 163:737–738PubMedGoogle Scholar
  16. 16.
    Rubin GD, Beaulieu CF, Argiro V et al (1996) Perspective volume rendering of CT and MR images: applications for endoscopic imaging. Radiology 199:321–330PubMedGoogle Scholar
  17. 17.
    Katz M, Konen E, Rozsenman J et al (1995) Spiral CT and 3D image reconstruction of vascular ring and associated tracheobronchial anomalies. J Comput Assist Tomogr 19:564–568CrossRefPubMedGoogle Scholar
  18. 18.
    Hopkins KL, Patrick LE, Simoneaux SF, Bank ER et al (1996) Pediatric great vessel anomalies: initial clinical experience with spiral CT angiography. Radiology 200:811–815PubMedGoogle Scholar
  19. 19.
    Quint LE, Francis IR, Williams DM et al (1996) Evaluation of thoracic aortic disease with the use of helical CT and multiplanar reconstructions: comparison with surgical findings. Radiology 201:37–41PubMedGoogle Scholar
  20. 20.
    Masuda Y, Takanashi K, Takasu J (1992) Expansion rate of thoracic aortic aneurysms and influencing factors. Chest 102:461–466CrossRefPubMedGoogle Scholar
  21. 21.
    Dapunt L, Galla JD, Sadeghi AM et al (1994) The natural history of thoracic aortic aneurysms. J Thorac Cardiovasc Surg 107:1323–1333PubMedGoogle Scholar
  22. 22.
    Cigarroa JE, Isselbacher EM, DeSanctis RW, Eagle KA (1993) Medical progress. diagnostic imaging in the evaluation of suspected aortic dissection: old standards and new directions. AJR Am J Roentgenol 161:485–493Google Scholar
  23. 23.
    Erbel R, Daniel W, Visser C et al (1989) Echocardiography in diagnosis of aortic dissection. Lancet March 4:457–461CrossRefGoogle Scholar
  24. 24.
    Nienaber CA, Kodolitsch Yv, Nicolas V et al (1993) The diagnosis of thoracic aortic dissection by noninvasive imaging procedures. NEJM 328:1–9CrossRefPubMedGoogle Scholar
  25. 25.
    Nienaber CA, Kodolitsch Yv, Petersen B et al (1995) Intramural hemorrhage of the thoracic aorta: diagnostic and therapeutic implications. Circulation 92:1465–1472PubMedGoogle Scholar
  26. 26.
    Kazerooni EA, Bree RL, Williams DM (1992) Penetrating atherosclerotic ulcers of the descending thoracic aorta: evaluation with CT and distinction from aortic dissection. Radiology 183:759–765PubMedGoogle Scholar
  27. 27.
    Gore I (1952) Pathogenesis of dissecting aneurysm of the aorta. Arch Pathol Lab Med 53:142–153Google Scholar
  28. 28.
    Mirvis SE, Shanmuganathan K, Miller BH et al (1996) Traumatic aortic injury: diagnosis with contrast-enhanced thoracic CT-five year experience at a major trauma center. Radiology 200:413–422PubMedGoogle Scholar
  29. 29.
    Gavant ML, Manke PG, Fabian T et al (1995) Blunt traumatic aortic rupture: detection with helical CT of the chest. Radiology 197:125–133PubMedGoogle Scholar
  30. 30.
    Parker MS, Matheson TL, Rao AV et al (2001) Making the transition: the role of helical CT in the evaluation of potentially acute thoracic aortic injuries. AJR Am J Roentgenol 176:1267–1272PubMedGoogle Scholar
  31. 31.
    Dyer DS, Moore EE, Mestek MF et al (1999) Can chest CT be used to exclude aortic injury? Radiology 213:195–202PubMedGoogle Scholar
  32. 32.
    Armerding MD, Rubin GD, Beulieu CF et al (2000) Aortic aneurysmal disease: assessment of stent-graft treatment-CT versus conventional angiography. Radiology 215:138–146PubMedGoogle Scholar
  33. 33.
    Rubin GD, Dake MD, Napel SA et al (1993) Abdominal spiral CT angiography: Initial clinical experience. Radiology 186:147–152PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Geoffrey D. Rubin
    • 1
  • Mannudeep K. Kalra
    • 2
  1. 1.Department of RadiologyStanford University School of MedicineStanfordUSA
  2. 2.Department of RadiologyMassachusetts General HospitalBostonUSA

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