Thorakale Aortendissektion - Stellenwert von MRT und CT in der Verlaufskontrolle nach prothetischem Aortenersatz

Abstract

Dynamic CT and MRT were performed in 21 patients who had undergone prosthetic replacement of the aorta because of dissection of the thoracic aorta. There is no difference between MRI and dynamic CT in the demonstration of a persistent intimal flap, the formation of a thrombus and the assessment of the aortic diameter in patients who underwent surgery for thoraco-abdominal aortic dissection. MRI, however, is superior in the identification of the true and false lumen and the demonstration of the distal anastomotic site. The major advantages of MRI are that there is no need for intravenous contrast agents, that it is highly sensitive to flow phenomena, and that it can demonstrate the aortic arch and the ascending aorta on sagittal oblique sections. The major disadvantages of MRI are the limited access to the patient during the procedure, and the inability to examine patients fitted with pacemakers or who are on assisted ventilation. Today, MRI is considered the method of first choice for the postoperative follow-up of patients who underwent surgery for aortic dissection.

Effect of medical and surgical therapy on aortic dissection evaluated by transesophageal echocardiography. Implications for prognosis and therapy. The European Cooperative Study Group on Echocardiography.

“…Computed tomography and magnetic resonance imaging can be used to obtain this additional information. 43,49 Intravascular ultrasound also appears to be a promising new technique that may overcome current limitations.50 The information not obtained for these reasons would not have influenced the conclusion of this study insofar as the other parts of the aorta are very well imaged, allowing the detection of entry tears, thrombus formation, intimal flaps, and flow in the true and false lumens.…”