Motion characterization of aortic wall and intimal flap by ECG-gated CT in patients with chronic B-dissection.
OBJECTIVE
To evaluate whether dynamic computed tomography (CT)-imaging can provide functional vessel information in patients with chronic aortic dissection type Stanford-B (ADB).


METHODS
In 32 patients, ECG-gated CT-angiography images were obtained. Cross-sectional area change and wall distensibility were investigated by semiautomatic vessel area segmentation at the end of aortic arch. Significance of distensibility differences was tested with regard to the aortic diameter, and the oscillation of the intimal flap was analyzed.


RESULTS
The aorta could be segmented successfully in all patients. These were separated into three subgroups: (A) 6 patients with an aortic diameter <4 cm and without a visible intimal flap, (B) 9 patients with an aortic diameter <4 cm, and (C) 17 individuals with an aortic diameter > or = 4 cm; (B) and (C) having a visible intimal flap. Differences in distensibility between the subgroups were not significant. Overall mean distensibility was D(tot)=(1.3+/-0.6) x 10(-5) Pa(-1). Analysis of intimal flap oscillation showed a pulsatile short axis diameter decrease of the true lumen of up to 29%.


CONCLUSIONS
Dynamic, ECG-gated CT-angiography can demonstrate pulsatile changes in aortic area and a highly variable motion of the intimal flap. Aortic distensibility appears independent of diameter or presence of a intimal flap. Follow-up studies may show correlation with possible complications.
Ganten
Maria-Katharina
MK
Department of Radiology, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany. m.ganten@dkfz-heidelberg.de
Weber
Tim F
TF
von Tengg-Kobligk
Hendrik
H
Böckler
Dittmar
D
Stiller
Wolfram
W
Geisbüsch
Philipp
P
Kauffmann
Günter W
GW
Delorme
Stefan
S
Bock
Michael
M
Kauczor
Hans-Ulrich
HU
D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging*; D001027:Aortography / Q000379:methods*; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*