Abstract
Article: The Role of CTA, MRA, and Sonography in Aortic Dissection
Author: Amanda Sentz, RDMS, RVT
Category: Vascular
Credit: 1.0 SDMS CME Credit
Objectives: After studying the article entitled “The Role of CTA, MRA, and Sonography in Aortic Dissection,” you will be able to:
Describe the different types of aortic dissection.
Determine appropriate imaging modalities to diagnose aortic dissection.
Explain the role of sonography in the management of aortic dissection.
The most common type of aortic dissection is the Stanford Type A Stanford Type B DeBakey Type I DeBakey Type II
An aortic dissection is a widening of the aortic lumen caused by weakening of the adventitia penetration of the aortic wall creating a saccular pouch with blood flow the creation of 2 lumens by separation of the intimal and medial layers partial obstruction of flow caused by congenital aortic narrowing
An aortic dissection that originates distal to the innominate artery is a Stanford Type A Stanford Type B DeBakey Type I DeBakey Type II
Typical symptoms of an aortic dissection include chest pain back pain shortness of breath all of the above
A rapid, readily accessible technique to demonstrate different flow hemodynamics in the 2 lumens of an aortic dissection is color Doppler sonography sonographic gray-scale imaging computed tomography without contrast computed tomographic angiography
A principal advantage of computed tomographic angiography is low cost the ability to provide good images in the presence of patient motion the use of hypo-osmolar contrast agents ability to show the entire extent of the dissection
Transesophageal echocardiography has been shown to have a sensitivity and specificity for aortic dissection of > 80% > 90% > 95% > 99%
The primary role of magnetic resonance angiography in aortic dissections is diagnosis in the acute setting quantifying lumen diameter at the site of dissection routine follow-up of non-operated dissections imaging unstable patients
Patients who have surgery for Stanford Type B aortic dissections have a mortality rate of approximately 60% 30% 20% 10%
Medical management is typically used for aortic dissections classified as Stanford Type A Stanford Type B DeBakey Type I DeBakey Type II
Footnotes