Thoracic aortic dissection: diagnosis with transesophageal echocardiography versus MR imaging.
OBJECTIVE
To compare transesophageal echocardiography (TEE) and magnetic resonance (MR) imaging in the diagnosis of dissection of the thoracic aorta.


METHODS
Thirty-one consecutive patients with clinically suspected aortic dissection and 10 postoperative patients underwent transesophageal color Doppler echocardiography and MR imaging. Imaging results were compared at independent double-blind readings. Final diagnosis was obtained from consensual review of all corroborative studies.


RESULTS
MR imaging depicted the intimal flap in 95% of aortic dissections; TEE, in 86% (P < .05). In surgical patients, the sensitivity of MR in detection of residual dissection was 100% versus 86% with TEE (P < .05). The inferior extent of the dissected lumen was seen only with MR imaging. False-positive results occurred in two cases with TEE and in one with MR imaging.


CONCLUSIONS
MR imaging is superior to TEE in the evaluation and follow-up of dissection of the thoracic aorta. Because the availability of MR is limited, however, TEE should remain the standard modality for diagnosis.
Laissy
J P
JP
Department of Radiology, University Bichat Claude-Bernard, Paris, France.
Blanc
F
F
Soyer
P
P
Assayag
P
P
Sibert
A
A
Tebboune
D
D
Arrivé
L
L
Brochet
E
E
Hvass
U
U
Langlois
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D001011:Aorta / Q000000981:diagnostic imaging; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D001027:Aortography; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity