HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text All Versions of this Article: 2282012162v1 228/2/430    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yoshida, S. Articles by Abe, T. Search for Related Content PubMed PubMed Citation Articles by Yoshida, S. Articles by Abe, T.

Thoracic Involvement of Type A Aortic Dissection and Intramural Hematoma: Diagnostic Accuracy—Comparison of Emergency Helical CT and Surgical Findings¹

¹ From the Departments of Radiology (S.Y., H.A., M.T., N.Y., M.H.) and Cardiovascular Surgery (K.M., T.A.), Sapporo Medical University, School of Medicine, Japan. From the 1999 RSNA scientific assembly. Received January 14, 2002; revision requested March 5; final revision received September 9; accepted December 10. Address correspondence to S.Y., Department of Radiology, Muroran City General Hospital, Yamate-chou 3-8-1, Muroran 051-8512, Japan (e-mail: satyoshi@chive.ocn.ne.jp).

PURPOSE: To assess the accuracy of various findings at emergency helical computed tomography (CT) for the evaluation of thoracic involvement of type A aortic dissection (AD) and type A intramural hematoma (IMH) and to compare these findings with those at surgical confirmation.

MATERIALS AND METHODS: Fifty-seven patients with acute chest pain underwent emergency helical CT and subsequent surgery for type A AD or IMH. Patients in whom AD or IMH was detected in three segments of the thoracic aorta or those in whom there was a site of any entry tear, arch branch vessel involvement, pericardial effusion, or aortic arch anomaly were examined at helical CT. Sensitivity, specificity, and accuracy of helical CT, along with 95% CIs, were calculated by using surgical confirmation as the reference standard.

RESULTS: For the detection of AD or IMH of the thoracic aorta, the accuracy of helical CT was 100%. The sensitivity, specificity, and accuracy, respectively, were 82%, 100%, and 84% for an entry tear; 95%, 100%, and 98% for arch branch vessel involvement; and 83%, 100%, and 91% for pericardial effusion. These values were all 100% for aortic arch anomalies.

CONCLUSION: Emergency helical CT of the thorax depicts findings that are highly accurate in the evaluation of acute type A AD and IMH.

© RSNA, 2003

Index terms: Aorta, CT, 56.12111, 56.12112, 56.12115 • Aorta, dissection, 56.74 • Computed tomography (CT), helical, 56.12111, 56.12112, 56.12115

This article has been cited by other articles:

				P. D. Patel and R. R. Arora Pathophysiology, diagnosis, and management of aortic dissection Therapeutic Advances in Cardiovascular Disease, December 1, 2008; 2(6): 439 - 468. [Abstract] [PDF]

				J. D. Dodd, S. Kalva, A. Pena, F. Bamberg, M. D. Shapiro, S. Abbara, R. C. Cury, T. J. Brady, and U. Hoffmann Emergency Cardiac CT for Suspected Acute Coronary Syndrome: Qualitative and Quantitative Assessment of Coronary, Pulmonary, and Aortic Image Quality Am. J. Roentgenol., September 1, 2008; 191(3): 870 - 877. [Abstract] [Full Text] [PDF]

				M R Jones and J H Reid Emergency chest radiology: thoracic aortic disease and pulmonary embolism Imaging, September 1, 2006; 18(3): 122 - 138. [Abstract] [Full Text] [PDF]

				T. Shiga, Z. Wajima, C. C. Apfel, T. Inoue, and Y. Ohe Diagnostic Accuracy of Transesophageal Echocardiography, Helical Computed Tomography, and Magnetic Resonance Imaging for Suspected Thoracic Aortic Dissection: Systematic Review and Meta-analysis. Arch Intern Med, July 10, 2006; 166(13): 1350 - 1356. [Abstract] [Full Text] [PDF]

				V. D. Raptopoulos, P. B. Boiselle, N. Michailidis, J. Handwerker, A. Sabir, J. A. Edlow, I. Pedrosa, and J. B. Kruskal MDCT Angiography of Acute Chest Pain: Evaluation of ECG-Gated and Nongated Techniques Am. J. Roentgenol., June 1, 2006; 186(6_Supplement_2): S346 - S356. [Abstract] [Full Text] [PDF]

				R. G. Hayter, J. T. Rhea, A. Small, F. S. Tafazoli, and R. A. Novelline Suspected Aortic Dissection and Other Aortic Disorders: Multi-Detector Row CT in 373 Cases in the Emergency Setting Radiology, March 1, 2006; 238(3): 841 - 852. [Abstract] [Full Text] [PDF]

				H. Alkadhi, S. Wildermuth, L. Desbiolles, T. Schertler, D. Crook, B. Marincek, and T. Boehm Vascular Emergencies of the Thorax after Blunt and Iatrogenic Trauma: Multi-Detector Row CT and Three-dimensional Imaging RadioGraphics, September 1, 2004; 24(5): 1239 - 1255. [Abstract] [Full Text] [PDF]