|
1. |
Approach to Aortic Dissection |
|
Contemporary Diagnostic Radiology,
Volume 19,
Issue 20,
1996,
Page 1-5
RENATE SOULEN,
PRISCILLA PETERS,
Preview
|
PDF (442KB)
|
|
摘要:
The purpose of this lesson is to discuss the various imaging examinations available for evaluation of aortic dissection.In the clinical setting of query aortic dissection, irnaging studies must permit rapid and accurate diagnosis. In addition, in order to assess prognosis and determine optimal treatment, these studies should answer the following questions: Is the ascending aorta involved? Where is the entry site? Is the aortic valve competent? Is there a pericardial efusion? What is the extent of tear? Are major branch vessels involved? Is the false lumen thrombosed?Ascending aortic involvement usually calls for surgery, even if the entry site is in or beyond the aortic arch. (It must be remembered that aortic dissection may progress retrogrcrde as well cis nntegrade from the site of intimal tear.) The location of the entry site determines the surgical approach (i.e., median sternotomy versus left thoracotoiny). A newly incompetent aortic valve makes surgery urgent; n pericardial effusion makes surgery emergent. The extent of tear and major brarich involvement affects both siirgicul risk and complications and may call, for vascular stentins. Thrombosis of the false lumen improves the prognosis but may cause diagnostic difficulties.Imaging approaches currently employed include aortography, computed tomography (CT), magnetic resonance imaaging/angiography (MRUMRA), and transesophageal echocardiography (TEE). Of these, the most comprehensive and acciircite is MRI/MRA, with sensitivity and specificity of 98% for each procedure in experienced hands.1,2
ISSN:0149-9009
出版商:OVID
年代:1996
数据来源: OVID
|
|