Impact of contrast-enhanced echocardiography on the diagnostic algorithm of acute aortic dissection

Abstract

Contrast enhancement substantially improves TTE in the diagnosis of AD and should be considered as the initial imaging modality in the emergency setting. Contrast enhancement also has significant value for obtaining critical morphological and haemokinetic information by TOE useful for adequate patient management.

Multimodality Imaging of Diseases of the Thoracic Aorta in Adults: From the American Society of Echocardiography and the European Association of Cardiovascular Imaging

“…However, because of new transducers with improved resolution, harmonic imaging, and contrast enhancement, the sensitivity of TTE has improved to approximately 85% on the basis of recent data from Cecconi et al 145 and Evangelista et al 146 Therefore, TTE may be of some use as the initial imaging modality, especially in the emergency room ( Figure 27). In addition, TTE provides assessment of left ventricular contractility, pericardial effusion, aortic valve function, right ventricular size and function, and pulmonary artery pressure, which may facilitate the diagnosis of chest pain due to myocardial ischemia and/or infarction, pulmonary embolism, or pericardial disease and may identify dissection complications such as aortic regurgitation (AR) in an early fashion.…”

A case of circumferential type A aortic dissection with intimal intussusception diagnosed using repeat transthoracic echocardiography examination

“…The sensitivity and specificity of TTE for diagnosing this condition are 82.2% and 89.2%, respectively, and those of TEE are 95.6% and 96.4%, respectively 8. Although TEE has a higher accuracy, it can only be carried out by an experienced cardiologist.…”

Acute Thoracic Aortic Dissection (Stanford B): Challenges in Early Detection and Management

“…The sensitivity of TEE has higher sensitivity in type A (sensitivity 93% and specificity 97%) than type B (sensitivity 84% and specificity 94%.) [8]. Nevertheless, since the patient was in pain complicated with anterolateral myocardial infacrtion, the procedure was deferred to CT.…”