Diagnostic imaging of aortic diseases |
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Authors: | C A Nienaber Y von Kodolitsch |
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Institution: | Abteilung Innere Medizin, Kardiologie, Universit?tskrankenhaus Eppendorf, Hamburg, XX
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Abstract: | Summary
The aim of this overview is the comparison between noninvasive tomographic imaging modalities such as surface echocardiography,
transesophageal echocardiography, X-ray computed tomography and magnetic resonance imaging with the previous gold standard
angiography in the setting of acute and chronic aortic diseases.
Methods: The groundwork for the comparison between various noninvasive modalities is the validation of findings with angiography or
intraoperative and histopathological results.
Results and conclusions: Noninvasive modalities such as transesophageal echocardiography, X-ray computed tomography and magnetic resonance imaging
are suitable methods for reliable diagnosis or exclusion of aortic dissection both in the ascending and descending segment
of the thoracic aorta. Other more rare pathologies of the aorta such as intramural hemorrhage as a precursor of dissection,
aortic ulcers, aneurysms as well as congenital and posttraumatic lesions may also be subjected to transesophageal echocardiography
or magnetic resonance imaging with excellent sensitivity and specificity; both techniques have also proven to be safe procedures
in critically ill patients and have, in our view, replaced angiography for the diagnosis of acute aortic syndromes. Thus,
in acute aortic diseases invasive angiographic procedures should be relegated to a complementary role, while transesophageal
echocardiography, X-ray computed tomography (especially helical CT) in acute, and magnetic resonance imaging in chronic cases
represent prefered diagnostic options. In addition to primary diagnostics the noninvasive approaches using transesophageal
echocardiography and magnetic resonance imaging are superbly suitable for serial follow-up imaging in all forms of aortic
pathology.
Eingegangen am 23. Januar 1997 Angenommen am 23. Januar 1997 |
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Keywords: | X-ray computed tomography • Magnetic resonance imaging • Transesophageal echocardiography • Aortic dissection • Aneurysm intramural hemorrhage • Trauma |
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