Chronic aortic dissection: comparison of MR Imaging and transesophageal echocardiography.
OBJECTIVE
To compare the diagnostic value of magnetic resonance (MR) imaging and transesophageal echocardiography (TEE) in the follow-up of chronic dissection of the thoracic aorta.


METHODS
Follow-up MR imaging and TEE were performed in 25 consecutive patients with aortic dissection. Ten patients had a type I dissection and 15 had a type III dissection. All patients with type I dissection underwent surgical intervention. Ten of 15 type III dissections were managed medically, and five were managed with surgical intervention.


RESULTS
Identification of a persisting dissection and differentiation of the true and false lumina were equal with both methods. The arch vessels and all anastomoses in the surgically treated patients could be assessed only with MR imaging. An intimal flap in the aortic root and formation of an aortic thrombus were visualized in more detail with TEE. At least one entry site could be detected with both methods in 86% of the patients. TEE demonstrated small entry sites more frequently.


CONCLUSIONS
MR imaging provides better visualization of anastomoses and easier comparison of serial studies; TEE should be employed if MR findings are equivocal.
Deutsch
H J
HJ
Klinik III fur Innere Medizin, University of Cologne, Germany.
Sechtem
U
U
Meyer
H
H
Theissen
P
P
Schicha
H
H
Erdmann
E
E
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D002908:Chronic Disease; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged