Acute Aortic Disease.. - Index of

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Imaging of Aneurysms and
Dissections: Chest X-Ray,
Echo, Computed Tomography,
Magnetic Resonance Imaging
Peter G. Danias
Department of Medicine, Tufts University Medical School, Boston,
Massachusetts, U.S.A., and Cardiac MR Center,
Hygeia Hospital, Maroussi, Athens, Greece
INTRODUCTION
Acute aortic pathology may not be a very common presentation of cardiovascular
disease, but, if undetected, it carries a significant mortality (1). As symptoms are
frequently vague, more than one-third of acute thoracic aortic dissection cases go
undiagnosed, while in approximately one-quarter of cases the diagnosis is first
established at the post mortem examination (2). Even when a timely diagnosis
is made, optimal therapy may differ depending on the extent and characteristics
of the underlying pathology. Thus appropriate management requires both a high
clinical index of suspicion to make the diagnosis and a precise knowledge of the
aortic anatomy to guide appropriate therapy. Aortic imaging is probably the most
important tool that the clinician has in hand when evaluating patients with known
or suspected aortic disease.
Imaging of the thoracic aorta has many objectives: The location and size
of the aorta must be assessed. Knowledge of the anatomic relationships with
other intrathoracic organs is of great importance, particularly for preoperative
planning. Similarly, the origin of branch vessels (arch vessels, intercostals, and
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