CT patterns of acute type A aortic arch dissection: longer, higher, more anterior

Ardellier, François-Daniel; D’Ostrevy, Nicolas; Cassagnes, L.; Ouchchane, Lemlih; Dubots, Emilie; Chabrot, P.; Boyer, L.; Camilleri, Lionel

doi:10.1259/bjr.20170417

Cited by 9 publications

(3 citation statements)

References 29 publications

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“…In most studies of routine CTA scanning of the aorta in patients with suspected interlining, the images are acquired 20-25 s after contrast medium injection; often for arterial hemodynamic changes, single-phase data may show little deviation or, because the blood ow velocity is slow, appear such as near the heart where imaging quality is higher, but the far heart end may have poor image quality [21][22][23]. In order to solve these problems, multiphase data can be acquired by dynamic scanning imaging within a range of 15-35 s to supplement the information missing in single-phase scanning.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of dynamic computed tomographic angiography for aortic dissection and the perfusion of involved organs

Song

Lyu

Wang

et al. 2022

Preprint

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Purpose: Early diagnosis of aortic dissection (AD) and end-organ malperfusion is of great significance for AD’s management and prognosis. This study aimed to evaluate the use of aortic dynamic computed tomography (CT) angiography (CTA) in diagnosing AD and the significance of evaluating blood supply to abdominal organs. Methods: The patients with confirmed AD and who visited our hospital from 12/2018 to 12/2019 were retrospectively included. The densities of the aortas and abdominal organs were measured, and a time-density curve was drawn and compared with conventional CTA. Correlation analysis was performed between the changes of densities in the false lumen and the changes of densities in injured kidneys. Results:Fifty patients were included. The tears were seen in 86%. The main aortic branches were involved in 48%. The diagnostic rate of dynamic angiography for rupture was 86%, slightly better than aortic CTA (84%, P<0.01; κ=0.765). The density of the true and false lumens was measured in each phase: phase 2 (4%), 3 (4%), 4 (48%), 5 (26%), and 6 (16%). Eighteen patients had single renal artery involvement. In phase 7, the density of the AD false lumen and kidney damage were correlated (r=0.75, P<0.001). Conclusions: Dynamic angiography can show the fine structures of AD. In dynamic angiography, the best phase can be selected according to the hemodynamic changes of patients to complete the diagnosis. False lumen density in phase 7 was correlated with renal injury.

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of dynamic computed tomographic angiography for aortic dissection and the perfusion of involved organs

Song

Lyu

Wang

et al. 2022

Preprint

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“…Such technological progress makes 3D indicators expected to be widely used. Therefore, numerous studies have focused on 3D parameters to confirm morphological differences other than diameter between the non-AAEs aorta and AAEs aorta (82). This shows that when formulating risk stratification thresholds, we should consider combining 3D parameters to characterize aortic risk morphology more precisely and improve the accuracy of diagnosis and prognosis (33).…”

Section: Other Morphological Indicatorsmentioning

confidence: 99%

New indicators for systematic assessment of aortic morphology: a narrative review

Luan¹,

Mao²,

Zhu³

et al. 2021

J Thorac Dis

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In order to prevent the occurrence of aortic adverse events in ascending thoracic aortic aneurysm patients, preventive surgery is the sole option in case of large aneurysm. Identifying high-risk patients timely and accurately requires effective predictive indicators of aortic adverse events and accurate risk stratification thresholds. Absolute diameter measured after a single imaging examination, which has been used as the predictive indicator for decades, has been proved to be ineffective for risk stratification in moderately dilated aorta. Previously, new indicators combining absolute diameters with personalized parameters have been reported to show better predictive power of aortic adverse events than absolute diameters by correcting the effect of these parameters on the diameters. Meanwhile, combining three-dimensional parameters to formulate risk stratification thresholds not only may characterize the aortic risk morphology more precisely, but also predict aortic adverse events more accurately. These new indicators may provide more systematic assessment methods of patients' risk, formulate more personalized intervention strategies for ascending thoracic aortic aneurysm patients, and also provide a basis for researchers to develop more accurate and effective risk thresholds. We also highlight that the algorithm obtained by combining multiple indicators may be a better choice compared with single indicator, but this still requires the support of more evidence.Due to the particularity of syndromic aortic disease, whether these new indicators can be used for its risk stratification is still uncertain. Therefore, the scope of this manuscript does not include this kind of disease.

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“…Sie können das Gefäß ganz oder teilweise (partieller Füllungsdefekt, umgeben von Kontrastmittel) ausfüllen. Begleitend kann der Pulmonalarterienhauptstamm erweitert sein ( > 29 mm bei Männern, > 27 mm bei Der Nachweis der Aortendissektion gelingt in der EKGgetriggerten CT-Angiografie durch die Darstellung der von den übrigen Wandschichten separierten Intima, die nach Ablösung als Dissektionsmembran ein meist zweigeteiltes oder sogar dreigeteiltes (Mercedes-Stern-)Lumen bedingt[26]. Das eigentliche, wahre Gefäßlumen der Aorta ist oft kleiner als das falsche Lumen und weist im Gegensatz zum falschen Lumen (sofern vorhanden) Kalzifikationen auf.…”

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Typische Probleme und Fehler im radiologischen Nachtdienst

Storjohann¹,

Pusch²,

Kessler³

et al. 2023

Radiopraxis

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Außerhalb der Regelarbeitszeit wird der Präsenzdienst in den meisten Krankenhäusern von Weiterbildungsassistenten geleistet. Sie sind gut beraten, einerseits die wichtigsten Krankheitsbilder zu kennen, die in dieser Übersichtsarbeit dargestellt werden, und andererseits die Fälle, die sie nicht lösen können, an ihren Hintergrund weiterzuleiten.

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CT patterns of acute type A aortic arch dissection: longer, higher, more anterior

Cited by 9 publications

References 29 publications

Diagnostic value of dynamic computed tomographic angiography for aortic dissection and the perfusion of involved organs

Diagnostic value of dynamic computed tomographic angiography for aortic dissection and the perfusion of involved organs

New indicators for systematic assessment of aortic morphology: a narrative review

Typische Probleme und Fehler im radiologischen Nachtdienst

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