Mimics of Complications in the Postsurgical Aorta at CT

Abstract

Various surgical techniques of the aorta result in expected imaging appearances on CT images that resemble complications such as pseudoaneurysm, perigraft abscess, and dissection. Awareness of these techniques, understanding the clinical situation in which they are performed, and familiarity with the typical appearances and locations of these mimics are essential for accurate interpretation. CT imaging techniques such as electrocardiographic gating and inclusion of a precontrast series can help distinguish an expected postsurgical finding from a complication. Information in the medical record, particularly the operative note, can clarify challenging cases with unusual imaging features. This review article provides examples of expected postsurgical findings at CT mimicking complications.© RSNA, 2019 M ajor complications of the postsurgical aorta, such as pseudoaneurysm, perigraft abscess, and dissection, are rare but associated with significant morbidity. Conversely, various operative techniques result in anticipated imaging appearances that resemble these same complications. The potential to avoid increased surveillance or repeat operation highlights the importance of identifying expected findings and distinguishing them from adverse findings. The purpose of this article was to review surgical techniques with postoperative imaging findings that mimic complications and the clinical scenarios in which they are performed. From the Departments of Radiology (D.B.G., D.B.V.

Late detachment of ascending aortic graft mimicking pseudoaneurysm and dissection: A case report

“…In fact, most of the surgical materials used in cardiac surgery, such as felt strips, grafts, and pledgets, have a very high attenuation on unenhanced CT miming contrast material, but they are usually not visible on enhanced images [ 4 , 9 ].…”