Chest CT Angiography for Acute Aortic Pathologic Conditions: Pearls and Pitfalls.

Radiographics

From the Department of Radiology, NYU Langone Health, 660 First Ave, Room 747, New York, NY 10016 (J.P.K., J.M.G., L.A.L., L.A., E.K.G., W.M.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (S.P.); and Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland (B.H.).

Published: November 2021

Chest CT angiography (CTA) is essential in the diagnosis of acute aortic syndromes. Chest CTA quality can be optimized with attention to technical parameters pertaining to noncontrast imaging, timing of contrast-enhanced imaging, contrast material volume, kilovolt potential, tube-current modulation, and decisions regarding electrocardiographic-gating and ultra-fast imaging, which may affect the accurate diagnosis of acute aortic syndromes. An understanding of methods to apply to address suboptimal image quality is useful, as the accurate identification of acute aortic syndromes is essential for appropriate patient management. Acute aortic syndromes have high morbidity and mortality, particularly when involving the ascending aorta, and include classic aortic dissection, penetrating atherosclerotic ulcer, and acute intramural hematoma. An understanding of the pathogenesis and distinguishing imaging features of acute aortic syndromes and aortic rupture and some less common manifestations is helpful when interpreting imaging examinations. Related entities, such as ulcerated plaque, ulcerlike projections, and intramural blood pools, and mimics, such as vasculitis and aortic thrombus, are important to recognize; knowledge of these is important to avoid interpretive pitfalls. In addition, an awareness of postsurgical aortic changes can be useful when interpreting CTA examinations when patient history is incomplete. The authors review technical considerations when performing CTA, discuss acute aortic syndromes, and highlight diagnostic challenges encountered when interpreting aortic CTA examinations. RSNA, 2021.

Download full-text PDF

Source
http://dx.doi.org/10.1148/rg.2021200055DOI Listing

Publication Analysis

Top Keywords

acute aortic
28
aortic syndromes
24
aortic
12
chest angiography
8
acute
8
diagnosis acute
8
cta examinations
8
syndromes
6
cta
5
imaging
5

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!