Aortic dissection: a comparative study of diagnosis with spiral CT, multiplanar transesophageal echocardiography, and MR imaging.
OBJECTIVE
To compare the usefulness of spiral computed tomography (CT), multiplanar transesophageal echocardiography (TEE), and magnetic resonance (MR) imaging in the diagnosis of thoracic aortic dissection and arch vessel involvement.


METHODS
Forty-nine symptomatic patients with clinically suspected aortic dissection were examined with contrast material-enhanced spiral CT, multiplanar TEE, and 0.5-T MR imaging (T1-weighted, cardiac-gated, spin-echo sequences). Imaging results were confirmed at autopsy (five patients), intraoperative exploration (23 patients), angiography (nine patients), and follow-up (12 patients).


RESULTS
Sensitivity in the detection of thoracic aortic dissection was 100% for all techniques. Specificity was 100%, 94%, and 94% for spiral CT, multiplanar TEE, and MR imaging, respectively. In the assessment of aortic arch vessel involvement, sensitivity was 93%, 60%, and 67%, respectively, and specificity was 97%, 85%, and 88%, respectively.


CONCLUSIONS
Spinal CT and multiplanar TEE are as valuable as MR imaging in the detection of thoracic aortic dissection. In the assessment of the supraaortic branches, spiral CT is superior (P<.05).
Sommer
T
T
Department of Radiology, University of Bonn, Germany.
Fehske
W
W
Holzknecht
N
N
Smekal
A V
AV
Keller
E
E
Lutterbey
G
G
Kreft
B
B
Kuhl
C
C
Gieseke
J
J
Abu-Ramadan
D
D
Schild
H
H
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods