[The application of intravascular ultrasound imaging in the diagnosis of aortic dissection].
OBJECTIVE
To evaluate the role of intravascular ultrasound (IVUS) imaging in the diagnosis of aortic dissection.


METHODS
Eighty-two patients with aortic dissection were admitted. The role of IVUS was evaluated and compared with CT, MRI, transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), Duplex scanning and digital subtraction angiography (DSA).


RESULTS
The different laminar appearance of the outer wall of the true and false lumen, characteristic alterations in the true and false lumen junction and the thrombosis in the false lumen detected by IVUS were useful to differentiate the true from the false lumen. Static and dynamic narrowing, causing visceral ischemia could be detected by IVUS imaging. The detection rate of entry site by IVUS was 100%, higher than CT (28%), MRI (22%), TTE (2%) and TEE (61%), P < 0.01, having no statistic difference with DSA (88%). The detection rate of the distal end of the dissection by IVUS was 100%, higher than Duplex (21%), P < 0.01, but had no statistic difference as compared with CT (89%) and MRI (86%). The detection rate of visceral arteries by IVUS was 98%, higher than CT (56%), MRI (57%), Duplex (17%) and DSA (66%), P < 0.01. The aortic diameter measured by IVUS was correlated well with CT measurement (r = 0.94, P < 0.01).


CONCLUSIONS
A full picture of aortic dissection can be obtained using IVUS imaging. It has an advantage over routine examinations in detecting visceral artery origin and clarifying visceral ischemia causes.
Jiang
Jun-hao
JH
Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Wang
Yu-qi
YQ
Fu
Wei-guo
WG
Guo
Da-qiao
DQ
Chen
Bin
B
Yang
Jue
J
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D001011:Aorta / Q000000981:diagnostic imaging; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018084:Ultrasonography, Interventional