Diagnostic Accuracy of Transesophageal Echocardiography, Helical Computed Tomography, and Magnetic Resonance Imaging for Suspected Thoracic Aortic Dissection

Abstract

All 3 imaging techniques, ie, TEE, helical CT, and MRI, yield clinically equally reliable diagnostic values for confirming or ruling out thoracic aortic dissection.

2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: Executive Summary

“…Reports of newer-generation multidetector helical CT scanners show sensitivities of up to 100% and specificities of 98% to 99%. [29][30][31][32] The sequence for a CT performed in the potential setting of acute AoD generally would include a noncontrast study to detect subtle changes of IMH, followed by a contrast study to delineate the presence and extent of the dissection flap, identify regions of potential malperfusion, and demonstrate contrast leak indicating rupture. Imaging of the vascular tree from the thoracic inlet to the pelvis, including the iliac and femoral arteries, provides sufficient information to plan surgical or endovascular treatment, if needed.…”

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

“…Computed tomography has been a widely used imaging technique for diagnosing aortic dissection, as the diagnostic accuracy was excellent (pooled sensitivity, 100%; pooled specificity, 98%) 6. Sometimes an intimal flap or tear at the proximal ascending aorta is not shown on enhanced CT, as in our case 3.…”

Magnetic Resonance Angiography of Aortic Diseases in Children

“…More recently, however, it has been shown that aortic dissection is diagnosed with equivalent reliability in a number of imaging modalities including echocardiography and computed tomography (Litmanovich et. al, 2009;Shiga et. al, 2006).…”