Multi-detector computed tomography in the diagnosis and management of acute aortic syndromes

• 作者: Anil G Hallinan JTPD
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: 急性大动脉的症候群 计算断层摄影术扫描 大动脉的解剖 内部 haematoma 渗透大动脉的溃疡 大动脉的动脉瘤
• 年，卷（期）: 2014,（6）
• 页码范围: 355-365
• 页数: 11页
• 分类号: R

摘要

Acute aortic syndrome(AAS) is a spectrum of conditions, which may ultimately progress to potentially life-threatening aortic rupture. This syndrome encompasses aortic dissection(AD), intramural haematoma, penetrating atherosclerotic ulcer and unstable thoracic aortic aneurysms. Multi-detector CT(MDCT) is crucial for the diagnosis of AAS, especially in the emergency setting due to its speed, accuracy and ready availability. This review attends to the value of appropriate imaging protocols in obtaining good quality images that can permit a confident diagnosis of AAS. AD is the most commonly encountered AAS and also the one with maximum potential to cause catastrophic outcome if not diagnosed and managed promptly. Hence, this review briefly addresses certain relevant clinical perspectives on this condition. Differentiating the false from the true lumen in AD is often essential; a spectrum of CT findings, e.g., 'beak sign', aortic 'cobwebs' that allows such differentiation have been described with explicit illustrations. The value of non enhanced CT scans, especially useful in the diagnosis of an intramural hematoma has also been illustrated. Overlap in the clinical and imaging features of the various conditions presenting as AAS is not unusual. However, on most instances MDCT enables the rightdiagnosis. On select occasions MRI or trans-esophageal echocardiography may be required as a problem solving tool.