MDCT in diagnosing acute aortic syndromes: reviewing common and less common CT findings

Valente, Tullio; Rossi, Giovanni; Lassandro, Francesco; Marino, Maurizio; Tortora, Giovanni; Muto, R.; Scaglione, Mariano

doi:10.1007/s11547-011-0747-9

Cited by 11 publications

(14 citation statements)

References 59 publications

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“…overlap between different entities, especially when the process is dynamic and evolving; these transitional and overlapping features, both clinical and pertaining to imaging findings, are sometimes definable as atypical and have led to misconceptions and controversies concerning the disease concept of AAS. [34][35][36][37]…”

Section: Typical and Atypical Mdct Findings Of Classic Double-barrel Admentioning

confidence: 99%

“…The FL is crescent shaped, with acute angles (beak sign 5 an acute angle between the dissection flap and the outer wall of the FL; the space formed by the acute angle could be filled with a high-attenuation material, contrast-enhanced blood, or a low-attenuation material in chronic dissections, haematoma) between the detached intima and the aortic wall ( Figure 6). 1,23,25,[34][35][36][37] Contrast enhancement between the arterial and venous phase is required to differentiate between the TL and partially thrombosed FL. In some cases, media-intima separation is not complete, and cobwebs or tendrils of the media layer (cobweb sign) persist between the intima and media, generally over short segments of the dissection.…”

Section: Classic Multidetector Ct Findings Of Aortic Dissectionmentioning

confidence: 99%

“…Pain recurrence in patients with AD should suggest the possibility of a three-channel dissection (Figure 12). 25,[35][36][37] This is more common in Marfan syndrome. (c) Limited intimal tear (Class 3), also known as "incomplete tear" or "subtle/discrete dissection", is a rare variant of AD qualified as a subtle, discrete dissection, in which the limited stellate or linear intimal tear is associated with exposure of the aortic media or adventitial layer and focal eccentric bulge at the tear site.…”

Section: Classic Multidetector Ct Findings Of Aortic Dissectionmentioning

confidence: 99%

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MDCT evaluation of acute aortic syndrome (AAS)

Valente¹,

Rossi²,

Lassandro³

et al. 2016

BJR

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Non-traumatic acute thoracic aortic syndromes (AAS) describe a spectrum of life-threatening aortic pathologies with significant implications on diagnosis, therapy and management. There is a common pathway for the various manifestations of AAS that eventually leads to a breakdown of the aortic intima and media. Improvements in biology and health policy and diffusion of technology into the community resulted in an associated decrease in mortality and morbidity related to aortic therapeutic interventions. Hybrid procedures, branched and fenestrated endografts, and percutaneous aortic valves have emerged as potent and viable alternatives to traditional surgeries. In this context, current state-of-the art multidetector CT (MDCT) is actually the gold standard in the emergency setting because of its intrinsic diagnostic value. Management of acute aortic disease has changed with the increasing realization that endovascular therapies may offer distinct advantages in these situations. This article provides a summary of AAS, focusing especially on the MDCT technique, typical and atypical findings and common pitfalls of AAS, as well as recent concepts regarding the subtypes of AAS, consisting of aortic dissection, intramural haematoma, penetrating atherosclerotic ulcer and unstable aortic aneurysm or contained aortic rupture. MDCT findings will be related to pathophysiology, timing and management options to achieve a definite and timely diagnostic and therapeutic definition. In the present article, we review the aetiology, pathophysiology, clinical presentation, outcomes and therapeutic approaches to acute aortic syndromes.

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Section: Typical and Atypical Mdct Findings Of Classic Double-barrel Admentioning

confidence: 99%

Section: Classic Multidetector Ct Findings Of Aortic Dissectionmentioning

confidence: 99%

Section: Classic Multidetector Ct Findings Of Aortic Dissectionmentioning

confidence: 99%

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MDCT evaluation of acute aortic syndrome (AAS)

Valente¹,

Rossi²,

Lassandro³

et al. 2016

BJR

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“…The intimal tear or 'flap' contains the false lumen and separates it from the true lumen, which is usually smaller [6].…”

Section: Aortic Dissectionmentioning

confidence: 99%

Acute aortic syndrome—pitfalls on gated and non-gated CT scan

2016

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Acute aortic syndrome (AAS) is a life-threatening condition which includes aortic dissection (AD), penetrating aortic ulcer (PAU) and intramural hematoma (IMH). Multi-detector computed tomography (MDCT) plays a crucial role in the diagnosis of this condition and for further clinical follow-up. It is important for radiologists to be aware of common pitfalls in cardiac-gated and non-gated CT in diagnosing AAS. They should also be wary of common mimics of AAS which may make a significant difference towards management of these patients. In this review, we present from our practice some of the common pitfalls and mimics of AAS on MDCT.

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“…Computed tomographic angiography (CTA) has high sensitivity and specificity for AAD diagnosis. The sensitivity and specificity of both methods for AAS diagnosis are close to 100% [8][9][10]. The mechanism of AAD has not been clarified.…”

mentioning

confidence: 97%

Branches of the brachiocephalic was an independent risk factor for hemorrhagic pulmonary sheath (HPS) patients with acute Stanford A aortic dissection

Xie¹,

Qin²,

Lin

et al. 2020

Preprint

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Background: AAD refers to the blood flow into the middle membrane through the intimal rupture of the aorta. Hemorrhagic pulmonary sheath (HPS) is a common complication of Stanford-A AAD. The risk factors of HPS are remaining unclear Methods: In this study, we have probed the potential risk factors of HPS patients with acute Stanford A aortic dissection. 18 HPS patients with acute Stanford A aortic dissection were selected as the case group. The age difference ± 5 years and the same sex are set as the matching principles. 36 patients with acute Stanford-A type AD who did not detect HPS in the same period were matched according to the ratio of 1:2. Demographic data, treatment methods, AD-related disease history, clinical symptoms and Charlson comorbidity index (CCI) values of each patient were collected. Meanwhile, the values of the maximum diameter of ascending aorta (mm), aortic dissection range, and the main branch of the aorta, pleural effusion/blood, and pericardial effusion/blood were measured by two experienced cardiovascular radiological physicians. Univariate and multivariate conditional logistic regression analysis was used in this study. Results: CCI value and the branches of the brachiocephalic in the case group were significantly higher than those in the control group (p<0.05). Univariate conditional logistic regression analysis showed CCI and branches of the brachiocephalic were associated with HPS. Multivariate conditional logistic regression analysis suggested that branches of the brachiocephalic were an independent risk factor for HPS (OR=7.02, 95%CI=1.28-38.62, p=0.025). Conclusions: Branches of the brachiocephalic were an independent risk factor for HPS.

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MDCT in diagnosing acute aortic syndromes: reviewing common and less common CT findings

Cited by 11 publications

References 59 publications

MDCT evaluation of acute aortic syndrome (AAS)

MDCT evaluation of acute aortic syndrome (AAS)

Acute aortic syndrome—pitfalls on gated and non-gated CT scan

Branches of the brachiocephalic was an independent risk factor for hemorrhagic pulmonary sheath (HPS) patients with acute Stanford A aortic dissection

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