The role of multidetector-row CT in the diagnosis, classification and management of acute aortic syndrome

• Published in: British journal of radiology Vol. 87; no. 1042; p. 20140354
• Main Authors: Abbas, A, Brown, I W, Peebles, C R, Harden, S P, Shambrook, J S
• Format: Journal Article
• Language: English
• Published: England The British Institute of Radiology 01.10.2014
• Subjects: Aneurysm, Dissecting - classification; Aneurysm, Dissecting - diagnostic imaging; Aorta, Thoracic - diagnostic imaging; Aortic Aneurysm - classification; Aortic Aneurysm - diagnostic imaging; Aortic Diseases - diagnostic imaging; Cardiac/Chest; Chest Pain - etiology; Diagnosis, Differential; Equipment Design; Hematoma - diagnostic imaging; Humans; Multidetector Computed Tomography - instrumentation; Review; Sensitivity and Specificity; Syndrome; Ulcer - diagnostic imaging
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr.20140354

The term "acute aortic syndrome" (AAS) encompasses several non-traumatic life-threatening pathologies of the thoracic aorta presenting in patients with a similar clinical profile. These include aortic dissection, intramural haematoma and penetrating atherosclerotic ulcers. These different pathological entities can be indistinguishable on clinical grounds alone and may be confused with other causes of chest pain, including myocardial infarction. Multidetector-row CT (MDCT) is the current modality of choice for imaging AAS with a sensitivity and specificity approaching 100%. Early diagnosis and accurate radiological classification is associated with improved clinical outcomes in AAS. We review the characteristic radiological features of the different pathologies that encompass AAS and highlight the vital role of MDCT in determining the management of these life-threatening conditions.