Current imaging in the diagnosis of acute aortic dissection.pdf

1、Aortic dissection (AD) is a rare and lethal disease with presenting signs and symptoms that can often be seen with other high risk conditions；diagnosis is therefore often delayed or missed.Pain is present in up to 90％ of

2、 cases and is typically severe at onset. Many patients present with acute on chronic hypertension, but hypotension is an ominous sign, often reflecting hemorrhage or cardiac tamponade. The chest x-ray can be normal in 10

3、-20% of patients with AD, and though transthoracic echocardiography is useful if suggestive findings are seen, and should be used to identify pericardial effusion,TTE cannot be used to excludeAD. Transesophageal echocard

4、iography, however, reliably confirms or excludes the diagnosis,where such equipment and expertise is available. CT scan with IV contrast is the most common imaging modality used to diagnose and classify AD, and MRI can b

5、e used in patients in whom the use of CT or IV contrast Is undesirable.Modern multidetector computed tomography (CT) is a fast, widely available imaging modality with high sensitivity and specificity. Multidetector CT al

6、lows the early recognition and characterization of aortic dissection as well as determination of the presence of any associated complications,findings that are essential for optimizing treatment and improving clinical ou