title: MDCT evaluation of acute aortic syndrome (AAS).
abstract: Non-traumatic acute thoracic aortic syndromes (AAS) describe a spectrum of life-threatening aortic pathologies with significant implications on diagnosis, therapy and management. There is a common pathway for the various manifestations of AAS that eventually leads to a breakdown of the aortic intima and media. Improvements in biology and health policy and diffusion of technology into the community resulted in an associated decrease in mortality and morbidity related to aortic therapeutic interventions. Hybrid procedures, branched and fenestrated endografts, and percutaneous aortic valves have emerged as potent and viable alternatives to traditional surgeries. In this context, current state-of-the art multidetector CT (MDCT) is actually the gold standard in the emergency setting because of its intrinsic diagnostic value. Management of acute aortic disease has changed with the increasing realization that endovascular therapies may offer distinct advantages in these situations. This article provides a summary of AAS, focusing especially on the MDCT technique, typical and atypical findings and common pitfalls of AAS, as well as recent concepts regarding the subtypes of AAS, consisting of aortic dissection, intramural haematoma, penetrating atherosclerotic ulcer and unstable aortic aneurysm or contained aortic rupture. MDCT findings will be related to pathophysiology, timing and management options to achieve a definite and timely diagnostic and therapeutic definition. In the present article, we review the aetiology, pathophysiology, clinical presentation, outcomes and therapeutic approaches to acute aortic syndromes.
authors.affiliation: 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy.
authors.forename: Tullio
authors.initials: T
authors.lastname: Valente
authors.affiliation: 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rossi
authors.affiliation: 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Lassandro
authors.affiliation: 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Rea
authors.affiliation: 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Marino
authors.affiliation: 1 Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Naples, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Muto
authors.affiliation: 2 Department of Pneumology, Section of Respiratory Diseases, University of Naples Federico II c/o Monaldi Hospital, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Molino
authors.affiliation: 3 Department of Diagnostic Imaging, Presidio Ospedaliero "Pineta Grande", Caserta, Italy.|4 Department of Radiology, Darent Valley Hospital, Darfford, UK.
authors.forename: Mariano
authors.initials: M
authors.lastname: Scaglione
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D001027:Aortography; D006406:Hematoma / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D061330:Multidetector Computed Tomography; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D013577:Syndrome; D014456:Ulcer / Q000150:complications / Q000000981:diagnostic imaging