A Pictorial Review of CT Angiography Imaging Features of Aortic Dissection and Its Complications: Role of Emergency Teleradiology

Abstract

Aortic dissection is an acute emergency affecting the aorta with a mortality of 50% in the first 48 hours of onset. The clinical outcome is determined by the type and extent of dissection, and its associated complications. Thus, knowledge of computed tomography (CT) angiography imaging features of aortic dissection and its complications, coupled with a process for immediate interpretation such as teleradiology, is essential for early diagnosis and treatment. The purpose of this study is to assess the imaging findings of aortic dissection and its complications on CT angiography and present a pictorial review of its imaging manifestations. We retrospectively evaluated 441 CT angiography studies diagnosed to have aortic dissection based on keyword search from emergency teleradiology reports. Noncontrast CT examinations were excluded from the study. The results were analyzed and compiled in a pictorial review. Aortic dissections are classified according to the Stanford classification system. Early diagnosis of aortic dissection and its complications is important in planning prompt management and avoiding fatal outcomes. CT angiography is a highly accurate noninvasive imaging investigation in the detection of aortic dissection and its complications. When coupled with emergency teleradiology analysis, the clinical outcomes can be significantly improved.

Keywords

aortic dissection - Stanford classification - teleradiology

Publikationsverlauf

Artikel online veröffentlicht:
24. März 2025

• References

• 1 Kruse MJ, Fishman EK, Zimmerman SL. Characterization of aortic dissection: what the radiologist needs to know. Curr Cardiovasc Imaging Rep 2014; 7: 9273
• 2 Baliga RR, Nienaber CA, Bossone E. et al. The role of imaging in aortic dissection and related syndromes. JACC Cardiovasc Imaging 2014; 7 (04) 406-424
• 3 McMahon MA, Squirrell CA. Multidetector CT of aortic dissection: a pictorial review. Radiographics 2010; 30 (02) 445-460
• 4 Murillo H, Molvin L, Chin AS, Fleischmann D. Aortic dissection and other acute aortic syndromes: diagnostic imaging findings from acute to chronic longitudinal progression. Radiographics 2021; 41 (02) 425-446
• 5 Orabi NA, Quint LE, Watcharotone K, Nan B, Williams DM, Kim KM. Distinguishing acute from chronic aortic dissections using CT imaging features. Int J Cardiovasc Imaging 2018; 34 (11) 1831-1840
• 6 Macura KJ, Corl FM, Fishman EK, Bluemke DA. Pathogenesis in acute aortic syndromes: aortic dissection, intramural hematoma, and penetrating atherosclerotic aortic ulcer. AJR Am J Roentgenol 2003; 181 (02) 309-316
• 7 Ito T, Yasuda N, Kuroda Y, Sugawara M, Koyanagi T, Higami T. Acute gallbladder necrosis in a patient with acute type B aortic dissection. Ann Vasc Dis 2013; 6 (04) 748-750
• 8 Khayat M, Cooper KJ, Khaja MS, Gandhi R, Bryce YC, Williams DM. Endovascular management of acute aortic dissection. Cardiovasc Diagn Ther 2018; 8 (1, Suppl 1): S97-S107