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Acute Aortic Disease.. - Index of

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78 Raghupathy and Eagle<br />

Table 6 A Summary <strong>of</strong> the Major Strengths and Limitations <strong>of</strong> CT, TTE, TEE, MRI,<br />

and Aortography<br />

Strengths Limitations<br />

Aortography Historical “gold standard” Invasive, requires arteriotomy<br />

Superior detection <strong>of</strong> localized tears Time-consuming<br />

Excellent assessment <strong>of</strong> branch vessels High-contrast exposure<br />

Can measure false lumen Limited detection <strong>of</strong> intramural<br />

hemodynamics<br />

Access for endovascular stenting<br />

or fenestration<br />

hematoma<br />

TTE Rapid/portable bedside use Limited spatial resolution<br />

Can assess for AI, LV function, Anatomic window limited to<br />

pericardial effusion and/or tamponade aortic root and heart,<br />

May identify dissection <strong>of</strong> aortic cannot assess extent <strong>of</strong><br />

root/proximal aorta dissection beyond<br />

aortic root<br />

TEE Portable Limited view <strong>of</strong> distal<br />

Excellent spatial resolution ascending aorta<br />

Safe in hemodynamically unstable (“blind spot”)<br />

patient Cannot assess distal abdominal<br />

Fast diagnosis (complete study in aorta<br />

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