The Diagnosis of Thoracic Aortic Dissection by Noninvasive Imaging Procedures

Abstract

A noninvasive diagnostic strategy using MRI in all hemodynamically stable patients and TEE in patients who are too unstable to be moved should be considered the optimal approach to detecting dissection of the thoracic aorta. Comprehensive and detailed evaluation can thus be reduced to a single noninvasive diagnostic test in the investigation of suspected dissection of the thoracic aorta.

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

“…30,[35][36][37][38][39] Advantages of MR include the ability to identify anatomic variants of AoD (IMH and PAU), assess branch artery involvement, and diagnose aortic valve pathology and left ventricular dysfunction without exposing the patient to either radiation or iodinated contrast. Disadvantages include prolonged duration of imaging acquisition during which the patient is inaccessible to care providers; inability to use gadolinium contrast in patients with renal insufficiency; contraindication in patients with claustrophobia, metallic implants or pacemakers, and lack of widespread availability on an emergency basis.…”

Para-aortic arch abscess secondary to Staphylococcus aureus pneumonia

“…MRI is an alternative imaging modality that avoids the risks of contrast and radiation exposure. In a prospective trial, the sensitivity and specificity of MRI were 98% and 85%, respectively (8).…”

“…Although reports of the sensitivity and specificity of standard CT for the diagnosis of aortic dissection are excellent (83% to 98% and 87% to 100%, respectively) (5,8,9), the intimal flap is seen in less than 75% of cases and the site of entry is rarely identified (6). MRI is an alternative imaging modality that avoids the risks of contrast and radiation exposure.…”

Hemoptise e hemotórax como apresentação de ruptura de aorta torácica

“…The transesophageal echocardiography shows sensitivity similar to angiotomography and aortic angioresonance in the dissection diagnosis [3]. In specific studies, it has shown a rapid and accurate method, reducing significantly the time to refer the patient for surgical treatment and therefore the mortality [4].…”