Spiral CT angiography and 3D reconstruction in patients with aortic coarctation

Abstract

The objective of this study was to assess the reliability of spiral CT angiography (CTA) and 3D reconstruction in patients with aortic coarctation (CoA). Eighteen patients with suspected or surgically proven coarctation were examined by spiral CT. In addition to the axial slices, 3D reconstructions, such as shaded surface display (SSD) and maximum intensity projection (MIP), were used to determine the diameters of the CoA and the pre- and poststenotic aorta and to visualise the collateral vessels. Diameters derived from cardiac catheterization were compared with those from CTA in 8 patients. The degree of aortic stenosis was correlated with blood pressure gradients (BPG) in 12 patients. The difference between the diameters of the CoA and the pre- and poststenotic aorta derived from MIP and angiography was not statistically significant (p = 0.69). With SSD the internal thoracic artery was detected in 16 and the posterior intercostal artery in 13 cases. The degree of aortic stenosis correlated poorly with the BPG (r = 0.51, r2 = 0.26). CTA with 3D reconstruction represents a reliable noninvasive technique for the assessment of the degree of CoA and the visualisation of collateral vessels. It may serve as a follow-up investigation after intervention or surgical treatment.

Multislice CT angiography

“…The high scan speed allows substantial reduction of the amount of contrast material [14]. Traditional spiral CT indications for imaging the thoracic aorta [12,13,25,52,53] have been reemphasized and strengthened with the introduction of multislice CT. CT angiography is the first-line modality for evaluation of degenerative or congenital aortic disease and for surgical planning prior to and for follow-up of cardiovascular interventions. The fast, high-resolution image acquisition capabilities of multislice CT has become very advantageous for quick and comprehensive exams in the initial diagnosis and followup of acute aortic injury, such as traumatic rupture or dissection of the vessel [52].…”

“…Acquisition of extensive volumes with submillimeter resolution generates nearly isotropic data that can be arranged in arbitrary imaging planes with the same high spatial resolution as in the original axial section. Acquisition of high-resolution multislice CT data enhances image quality of 2D and 3D renderings for visualization of vascular anatomy [24,25,26,27,28,29] and improves detection of minute pathology [20,21].…”

Elimination of errors caused by first-order aliasing in velocity encoded cine-MR measurements of postoperative jets after aortic coarctation: in vitro and in vivo validation

“…There are numerous imaging approaches in the preoperative stage and also in the postoperative follow-up of patients with aortic coarctation. For anatomic assessment of the coarctation site and identification of collaterals, non-invasive magnetic resonance imaging/angiography and also CT angiography show an equal sensitivity to invasive catheter angiography and thus are widely used as follow up tool [26,27,28,29]; however for functional assessment, the estimation of pressure gradients across the (re)stenosis by direct catheter measurement or with the use of Doppler echocardiography remains mandatory. There is very few experience with the use of VEC-MR in coarctation patients [8,30,31,32].…”

Coarctation of the aorta in adults: preoperative evaluation with MDCT angiography

“…On axial CT slices, the course of the aorta, the location of the coarctation, and the collateral vessels may not be clearly displayed; short segment coarctations, particularly, may be missed (14). The ability to visualize a vascular structure depends on the angle between these structures and the imaging plane.…”