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Aortic Dissection and Other Acute Aortic Syndromes: Diagnostic Imaging Findings from Acute to Chronic Longitudinal Progression. | LitMetric

Aortic Dissection and Other Acute Aortic Syndromes: Diagnostic Imaging Findings from Acute to Chronic Longitudinal Progression.

Radiographics

From the Department of Radiology, Enloe Medical Center, 1531 Esplanade, Chico, CA 95926 (H.M.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (L.M., D.F.); and Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada (A.S.C.).

Published: November 2021

AI Article Synopsis

  • Acute aortic dissection is a serious condition under the umbrella of acute aortic syndromes (AASs) that includes several other types of aortic issues, presenting with sudden, severe chest or back pain.
  • Accurate and rapid diagnostic imaging, primarily using CT scans, is crucial for confirming the type of AAS, assessing its severity, and planning interventions.
  • Different types of AAS have varying levels of urgency and complication rates; Stanford type A (involving the ascending aorta) requires immediate surgery, while type B (not involving the ascending aorta) generally has fewer acute complications.

Article Abstract

Acute aortic dissection is the prototype of acute aortic syndromes (AASs), which include intramural hematoma, limited intimal tear, penetrating atherosclerotic ulcer, traumatic or iatrogenic aortic dissection, and leaking or ruptured aortic aneurysm. The manifestation is usually sudden and catastrophic with acutely severe tearing chest or back pain. However, clinical symptoms do not allow distinction between AAS types and other acute pathologic conditions. Diagnostic imaging is essential to rapidly confirm and accurately diagnose the type, magnitude, and complications of AASs. CT fast acquisition of volumetric datasets has become instrumental in diagnosis, surveillance, and intervention planning. Most critical findings affecting initial intervention and prognosis are obtained at CT, including involvement of the ascending aorta, primary intimal tear location, rupture, malperfusion, size and patency of the false lumen, complexity and extent of the dissection, maximum caliber of the aorta, and progression or postintervention complications. Involvement of the ascending aorta-Stanford type A-has the most rapid lethal complications and requires surgical intervention to affect its morbidity and mortality. Lesions not involving the ascending aorta-Stanford type B-have a lesser rate of complications in the acute phase. During the acute to longitudinal progression, various specific and nonspecific imaging findings are encountered, including pleural and pericardial effusions, fluid collections, progression including aortic enlargement, and postoperative changes that can be discerned at CT. A systematic analysis algorithm is proposed for CT of the entire aorta throughout the continuum of AASs into the chronic and posttreated disease state, which synthesizes and communicates salient findings to all care providers. RSNA, 2021.

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Source
http://dx.doi.org/10.1148/rg.2021200138DOI Listing

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