MR angiography can guide ED management of suspected acute aortic dissection

Wang, Gary X.; Hedgire, Sandeep; Le, Thang Q.; Sonis, Jonathan D; Yun, Brian J.; Lev, Michael H.; Raja, Ali S.; Prabhakar, Anand M.

doi:10.1016/j.ajem.2016.11.039

Cited by 14 publications

(13 citation statements)

References 14 publications

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“…The sensitivity and specificity of CT are excellent [50], but in patients with poor renal function or allergy to iodinated dye, CT angiography is questionable and other imaging modalities such as magnetic resonance imaging (MRI) or ultrasonography can be considered instead. On the other hand, MRI is seldom used-as it is too time-consuming and still often unavailable, but it may complement CT angiography in follow-up imaging of the aorta [51].…”

Section: Diagnosismentioning

confidence: 99%

Acute type A aortic dissection – a review

Guðbjartsson

Ahlsson

Geirsson

et al. 2019

Scandinavian Cardiovascular Journal

107

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Acute type A aortic dissection (ATAAD) is still one of the most challenging diseases that cardiac surgeons encounter. This review is based on the current literature and includes the results from the Nordic Consortium for Acute Type-A Aortic Dissection (NORCAAD) database. It covers different aspects of ATAAD and concentrates on the outcome of surgical repair. The diagnosis is occasionally delayed, and ATAAD is usually lethal if prompt repair is not performed. The dynamic nature of the disease, the variation in presentation and clinical course, and the urgency of treatment require significant attentiveness. Many surgical techniques and perfusion strategies of varying complexity have been described, ranging from simple interposition graft to total arch replacement with frozen elephant trunk and valve-sparing root reconstruction. Although more complex techniques may provide long-term benefit in selected patients, they require significant surgical expertise and experience. Short-term survival is first priority so an expedited operation that fits in with the surgeon's level of expertise is in most cases appropriate. ARTICLE HISTORY Definitions and classification systemsDissection of the aorta occurs when the aortic media is separated, usually by pulsatile flow that penetrates the intimal layer of the aortic wall [14] (Figure 1(b)). This allows blood to flow between the layers of the aortic wall, forcing the layers apart, creating a false lumen parallel to the native (i.e. true) aortic lumen (Figure 1(b)). Consequently, the false lumen can propagate in both directions from the tear of intima and affect most of its distal branches, including the coronary, cerebral, and mesenteric arteries [15]. Another-but less common-CONTACT Tomas Gudbjartsson

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Section: Diagnosismentioning

confidence: 99%

Acute type A aortic dissection – a review

Guðbjartsson

Ahlsson

Geirsson

et al. 2019

Scandinavian Cardiovascular Journal

107

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“…However it is important to remember that both CT angiography and first-pass MRI have been shown to overestimate the amount of false lumen thrombosis by up to sixfold when compared to more advanced although not commonly available MRI protocols [19], hence the need for a high degree of circumspection when interpreting those investigations [16]. MR is a fastevolving technology, and it will certainly play an increasingly important role in acute aortic syndromes [20].…”

Section: Mr Imagingmentioning

confidence: 99%

Understanding Visceral Ischaemia in Acute Type B Dissection: State of the Art, Challenges and Future Perspectives

Donati

Patel

Sallam

2019

Visceral Vessels and Aortic Repair

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“…However, it is not the imaging modality of choice in diagnosis or long-term follow up for these conditions (25). Magnetic resonance angiography (MRA) can be used as an alternative to CTA in select cases when ionizing radiation or allergic reactions to iodinated intravenous contrast agents are to be avoided (26). Non-contrast MRA can also be performed in patients with renal dysfunction (26).…”

Section: Imaging Of Aas/aortic Emergenciesmentioning

confidence: 99%

“…Magnetic resonance angiography (MRA) can be used as an alternative to CTA in select cases when ionizing radiation or allergic reactions to iodinated intravenous contrast agents are to be avoided (26). Non-contrast MRA can also be performed in patients with renal dysfunction (26). The strengths and weaknesses of different imaging modalities have been summarized in Table 1.…”

Section: Imaging Of Aas/aortic Emergenciesmentioning

confidence: 99%

Acute aortic syndromes and aortic emergencies

Baliyan¹,

Parakh²,

Prabhakar³

et al. 2018

Cardiovasc. Diagn. Ther.

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Acute aortic syndrome (AAS) and emergencies are relatively uncommon but are considered as life threatening, potentially fatal conditions. Different forms of aortic emergencies/AAS are often clinically indiscernible. Prompt and accurate diagnosis of these entities significantly influences prognosis and guides therapy. We aim to elucidate the pertinent role that radiology plays in the management of acute aortic diseases, with contrast-enhanced computed tomography angiography (CTA) being the most rapid and robust imaging technique.

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MR angiography can guide ED management of suspected acute aortic dissection

Cited by 14 publications

References 14 publications

Acute type A aortic dissection – a review

Acute type A aortic dissection – a review

Understanding Visceral Ischaemia in Acute Type B Dissection: State of the Art, Challenges and Future Perspectives

Acute aortic syndromes and aortic emergencies

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