Follow-up of chronic thoracic aortic dissection: Comparison of transesophageal echocardiography and magnetic resonance imaging

• Published in: The American heart journal Vol. 131; no. 6; pp. 1156 - 1163
• Main Authors: Masani, Navroz D., Banning, Adrian P., Jones, Richard A., Ruttley, Michael S.T., Fraser, Alan G.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.06.1996; Elsevier
• Subjects: Adult; Aged; Aneurysm, Dissecting - diagnosis; Aneurysm, Dissecting - diagnostic imaging; Aorta, Thoracic; Aortic Aneurysm, Thoracic - diagnosis; Aortic Aneurysm, Thoracic - diagnostic imaging; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Chronic Disease; Diseases of the aorta; Echocardiography, Transesophageal; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Predictive Value of Tests; Prospective Studies; Sonography; Human; Echocardiography; Cardiovascular disease; Exploration; Nuclear magnetic resonance imaging; Esophagus; Vascular disease; Dissecting aneurysm; Thoracic aorta; Case study; Chronic; Ultrasonic transducer; Aortic disease
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(96)90091-5

Because survivors of thoracic aortic dissection require follow-up to detect prognostic factors such as intimal tears, persistent flow in the false lumen, and complications associated with grafts, we compared transesophageal echocardiography (TEE) with magnetic resonance imaging (MRI) prospectively in 14 patients 1 year after their initial examination. Residual dissection was identified by both techniques in 11 patients. Flow and/or thrombus in the false lumen were detected by TEE in 10 (91%) and 6 (55%) patients, respectively, and by MRI in 9 (82%) and 5 (45%), respectively ( p = NS); more tears were detected by TEE (2.5 ± 1.4 per patient vs 0.2 ± 0.4; p < 0.005). Satisfactory delineation of a graft in the ascending aorta was noted in all 8 (100%) of the surgically treated patients by TEE compared with 4 (50%) by MRI ( p < 0.005). The upper ascending aorta was visualized clearly in fewer patients by TEE than by MRI (7 [50%] vs 13 [93%]; p < 0.05), as were the origins of the head and neck vessels (10 [71%] vs 13 [93%], p = NS). We conclude that TEE and MRI are both suitable techniques for the follow-up of patients with aortic dissection. TEE is more sensitive in identifying prognostic factors. MRI has a complementary role, particularly in visualization of the upper ascending aorta and the head and neck vessels.