title: Abdominal aortic intimal flap motion characterization in acute aortic dissection: assessed with retrospective ECG-gated thoracoabdominal aorta dual-source CT angiography.
abstract: OBJECTIVE
  To evaluate the feasibility of dose-modulated retrospective ECG-gated thoracoabdominal aorta CT angiography (CTA) assessing abdominal aortic intimal flap motion and investigate the motion characteristics of intimal flap in acute aortic dissection (AAD).
  
  
  METHODS
  49 patients who had thoracoabdominal aorta retrospective ECG-gated CTA scan were enrolled. 20 datasets were reconstructed in 5% steps between 0 and 95% of the R-R interval in each case. The aortic intimal flap motion was assessed by measuring the short axis diameters of the true lumen and false lumen 2 cm above of celiac trunk ostium in different R-R intervals. Intimal flap motion and configuration was assessed by two independent observers.
  
  
  RESULTS
  In these 49 patients, 37 had AAD, 7 had intramural hematoma, and 5 had negative result for acute aortic disorder. 620 datasets of 31 patients who showed double lumens in abdominal aorta were enrolled in evaluating intimal flap motion. The maximum and minimum true lumen diameter were 12.2 ± 4.1 mm (range 2.6 ∼ 17.4) and 6.7 ± 4.1 mm (range 0 ∼ 15.3) respectively. The range of intimal flap motion in all patients was 5.5 ± 2.6 mm (range 1.8 ∼ 10.2). The extent of maximum true lumen diameter decreased during a cardiac cycle was 49.5% ± 23.5% (range 12% ∼ 100%). The maximum motion phase of true lumen diameter was in systolic phase (5% ∼ 40% of R-R interval). Maximum and minimum intimal flap motion was at 15% and 75% of the R-R interval respectively. Intimal flap configuration had correlation with the phase of cardiac cycle.
  
  
  CONCLUSIONS
  Abdominal intimal flap position and configuration varied greatly during a cardiac cycle. Retrospective ECG-gated thoracoabdominal aorta CTA can reflect the actual status of the true lumen and provide more information about true lumen collapse. This information may be helpful to diagnosis and differential diagnosis of dynamic abstraction.
authors: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, P.R. China.
authors: Shifeng
authors: S
authors: Yang
authors: Departments of Ultrasound, Shandong Provincial Hospital, Jinan, Shandong, P. R. China.
authors: Xia
authors: X
authors: Li
authors: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, P.R. China.
authors: Baoting
authors: B
authors: Chao
authors: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, P.R. China.
authors: Lebin
authors: L
authors: Wu
authors: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, P.R. China.
authors: Zhaoping
authors: Z
authors: Cheng
authors: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, P.R. China.
authors: Yanhua
authors: Y
authors: Duan
authors: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, P.R. China.
authors: Dawei
authors: D
authors: Wu
authors: Unit of Periodontology, University of Greifswald, Greifswald, Germany.
authors: Yiqiang
authors: Y
authors: Zhan
authors: CT Research Collaboration, Siemens Ltd., China, Beijing, P.R. China.
authors: Jiuhong
authors: J
authors: Chen
authors: Healthcare Sector, Siemens Ltd., China, Shanghai, P.R. China.
authors: Bo
authors: B
authors: Liu
authors: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, P.R. China.
authors: Xiaopeng
authors: X
authors: Ji
authors: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, P.R. China.
authors: Pei
authors: P
authors: Nie
authors: Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, P.R. China.
authors: Ximing
authors: X
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis* / Q000473:pathology; D000792:Angiography / Q000379:methods*; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000473:pathology; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*