Radiographics 1999 Jan-Feb;19(1):45-60; quiz 149-50
Aortic dissection: diagnosis and follow-up with helical CT.
Sebastia C, Pallisa E, Quiroga S, Alvarez-Castells A, Dominguez R, Evangelista
A.
Acute aortic dissection is a cardiovascular emergency that requires prompt
diagnosis and treatment. Helical computed tomography (CT) allows diagnosis of
acute aortic dissection with a sensitivity and specificity of nearly 100%. With
helical CT, a dissection involving the ascending aorta (type A in the Stanford
classification) can be differentiated from one distal to the left subclavian
artery (type B). Helical CT can also be used to identify atypical forms of
aortic dissection such as intramural hematoma, penetrating atherosclerotic
ulcer, ruptured type B dissection, and atypical configurations of the intimal
flap. Helical CT is useful in follow-up of aortic dissection by allowing
assessment of early and late changes after surgery or medical treatment. Such
changes include postoperative complications of type A dissection, healing of
intramural hematoma, progression of intramural hematoma, and aneurysms of the
true or false lumen. Helical CT can also be used to monitor potentially
life-threatening ischemic complications of abdominal branch vessels.
