Skip to main content

Abstract

Computed tomography angiography (CTA) is an established imaging technique providing highly accurate clinical information of the thoracic aorta. The widespread availability and round-the-clock accessibility of modern-day multidetector-row CT (MDCT) technology in virtually all emergency rooms, a proven track record of CTA with sensitivity and specificity approaching 100% for the detection of acute thoracic aortic disease and the ability to detect other potentially clinically important pathology has led to the replacement of conventional diagnostic angiography by CTA [1]. The development of CTA with ECG gating provides additional advantages by eliminating cardiac pulsation and motion artefacts, further extending the clinical applicability of CTA to include aortic-root imaging. ECG gating, when performed retrospectively over the entire cardiac cycle, allows cardiac phase-resolved (time-resolved) cine imaging and visualisation, adding yet another dimension (4D) to this robust technique.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hayter RG, Rhea JT, Small A et al (2006) Suspected aortic dissection and other aortic disorders: multi-detector row CT in 373 cases in the emergency setting. Radiology 238: 841–852

    Article  PubMed  Google Scholar 

  2. Vilacosta I, Roman JAS (2001) Acute aortic syndrome. Heart 85:365–368

    Article  PubMed  CAS  Google Scholar 

  3. Erbel R, Alfonso F, Boileau C et al (2001) Diagnosis and management of aortic dissection. Eur Heart J 22:1642–1681

    Article  PubMed  CAS  Google Scholar 

  4. Evangelista A, Mukherjee D, Mehta RH et al (2005) Acute intramural hematoma of the aorta: a mystery in evolution. Circulation 111:1063–1070

    Article  PubMed  Google Scholar 

  5. Hiratzka LF, Bakris GL, Beckman JA et al (2010) 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation 121:e266–369

    Article  PubMed  Google Scholar 

  6. Dake MD, Kato N, Mitchell RS et al (1999) Endovascular stent-graft placement for the treatment of acute aortic dissection. N Engl J Med 340:1546–1552

    Article  PubMed  CAS  Google Scholar 

  7. Dake MD, Wang DS (2006) Will stent-graft repair emerge as treatment of choice for acute type B dissection? Semin Vasc Surg 19:40–47

    Article  PubMed  Google Scholar 

  8. Svensson LG, Labib SB, Eisenhauer AC, Butterly JR (1999) Intimai tear without hematoma: an important variant of aortic dissection that can elude current imaging techniques. Circulation 99:1331–1336

    Article  PubMed  CAS  Google Scholar 

  9. Fleischmann D, Mitchell RS, Miller DC (2008) Acute aortic syndromes: new insights from electrocardiographically gated computed tomography. Semin Thorac Cardiovasc Surg 20: 340–347

    Article  PubMed  Google Scholar 

  10. Fedak PW, Verma S, David TE et al (2002) Clinical and patho-physiological implications of a bicuspid aortic valve. Circulation 106:900–904

    Article  PubMed  Google Scholar 

  11. Erdheim J (1929) Medionecrosis aortae idiopathica. Virch Arch Pathol Anat 273:454–479

    Article  Google Scholar 

  12. Erdheim J (1930) Medionecrosis aortae idiopathica cystica. Virch Arch Pathol Anat 276:187–229

    Article  Google Scholar 

  13. Daily PO, Trueblood HW, Stinson EB et al (1970) Management of acute aortic dissections. Ann Thorac Surg 10:237–247

    Article  PubMed  CAS  Google Scholar 

  14. Ergin MA, O’Connor J, Guinto R, Griepp RB (1982) Experience with profound hypothermia and circulatory arrest in the treatment of aneurysms of the aortic arch. Aortic arch replacement for acute arch dissections. J Thorac Cardiovasc Surg 84:649–655

    PubMed  CAS  Google Scholar 

  15. Williams DM, Cronin P, Dasika N et al (2006) Aortic branch artery pseudoaneurysms accompanying aortic dissection. Part I. Pseudoaneurysm anatomy. J Vasc Interv Radiol 17:765–771

    Article  PubMed  Google Scholar 

  16. Williams DM, Cronin P, Dasika N et al (2006) Aortic branch artery pseudoaneurysms accompanying aortic dissection. Part II. Distinction from penetrating atherosclerotic ulcers. J Vasc Interv Radiol 17:773–781

    Article  PubMed  Google Scholar 

  17. Chirillo F, Salvador L, Bacchion F et al (2007) Clinical and anatomical characteristics of subtle-discrete dissection of the ascending aorta. Am J Cardiol 100:1314–1319

    Article  PubMed  Google Scholar 

  18. Murray CA, Edwards JE (1973) Spontaneous laceration of ascending aorta. Circulation 47:848–858

    Article  PubMed  CAS  Google Scholar 

  19. Widder DJ, Novelline RA, Derkac WM (1983) Spontaneous nontraumatic rupture of the thoracic aorta. J Thorac Cardiovasc Surg 86:626–628

    PubMed  CAS  Google Scholar 

  20. Demers P, Miller DC, Mitchell RS et al (2004) Stent-graft repair of penetrating atherosclerotic ulcers in the descending thoracic aorta: mid-term results. Ann Thorac Surg 77:81–86

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag Italia

About this chapter

Cite this chapter

Fleischmann, D., Chin, A.S., Miller, D.C. (2011). Three- and Four-Dimensional Imaging in Acute Aortic Syndrome. In: Hodler, J., von Schulthess, G.K., Zollikofer, C.L. (eds) Diseases of the Heart and Chest, Including Breast 2011–2014. Springer, Milano. https://doi.org/10.1007/978-88-470-1938-6_19

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-1938-6_19

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1937-9

  • Online ISBN: 978-88-470-1938-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics