title: Usefulness of triphasic CT aortic angiography in acute and surveillance: Our experience in the assessment of acute aortic dissection and endoleak.
abstract: BACKGROUND
  Computed tomography angiography (CTA) has been widely used in the diagnostic evaluation of many aortic diseases, but no standardized techniques actually exist for aortic CTA. The aim of this study was to describe the usefulness of triphasic CTA in aortic assessment in both non-traumatic emergency and surveillance conditions.
  
  
  METHODS
  We performed non ECG-gated CTA examinations with a 64-slice CT scanner using a triphasic protocol consisting of an unenhanced acquisition, and two (early and delayed) contrastographic phases with a delay of 25-30 s and 100-120 s respectively after the injection of contrast medium. Were retrospectively selected adult patients with imaging findings of acute aortic dissection (AAD) or endoleak (EL) from November 2012 to November 2014.
  
  
  RESULTS
  AAD was detected in 36 (67%) patients: 23 type A-AADs, and 13 type B-AADs. The presence of EL was observed in 18 (33%) patients: 1 type Ia, 5 types IIa, 2 types IIb, 1 type IIIa and 9 types IIIb.
  
  
  CONCLUSIONS
  Triphasic CTA is useful to provide correct and prompt diagnosis of AAD in emergency, allowing the evaluation of type and atypical forms of AAD, and the identification of possible branch-vessel involvement and complications. During surveillance, triphasic CTA assures accurate and complete assessment of all known and unknown ELs and it is essential for first follow-up examination.
  
  
  CONCLUSIONS
  Triphasic CTA represents a reliable imaging tool for aortic assessment in both non-traumatic emergency and surveillance after endovascular aneurysm repair. Modified protocol could be employed in selected patients and tailored in their known disease.
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology, Second University of Naples, Naples, Italy. Electronic address: alfonso.reginelli@unina2.it.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Reginelli
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology, Second University of Naples, Naples, Italy. Electronic address: dott.ssacapasso@gmail.com.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Capasso
authors.affiliation: Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, Perugia, Italy. Electronic address: dott.enzo81@libero.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ciccone
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology, Second University of Naples, Naples, Italy. Electronic address: mariarosariacroce@tiscali.it.
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Croce
authors.affiliation: Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology, Second University of Naples, Naples, Italy. Electronic address: graziella.digrezia@libero.it.
authors.forename: Graziella
authors.initials: G
authors.lastname: Di Grezia
authors.affiliation: Department of Radiology, San Giovanni di Dio e Ruggi D'aragona Hospital, Salerno, Italy. Electronic address: mattcarb1@tin.it.
authors.forename: Mattia
authors.initials: M
authors.lastname: Carbone
authors.affiliation: Department of Medicine and Health Science, University of Molise, Campobasso, Italy. Electronic address: n.maggialetti@gmail.com.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maggialetti
authors.affiliation: Department of Clinical Science, University of L'Aquila, L'Aquila, Italy. Electronic address: antonio.barile@uniaq.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Barile
authors.affiliation: Department of Diagnostic Imaging and Radiotherapy, Radiology University of Turin, Turin, Italy. Electronic address: paolo.fonio@unito.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fonio
authors.affiliation: Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, Perugia, Italy. Electronic address: michelescialpi@libero.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Scialpi
authors.affiliation: Department of Medicine and Health Science, University of Molise, Campobasso, Italy. Electronic address: lucabrunese@libero.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Brunese
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D000072226:Computed Tomography Angiography; D003287:Contrast Media; D057867:Endoleak / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media
keywords: Acute aortic dissection; Computed tomography angiography (CTA); EVAR; Endoleaks; Triphasic CTA