nach oben

Erschienen in:

01.01.2009 | Vascular-Interventional

Assessment of thoracic aortic conformational changes by four-dimensional computed tomography angiography in patients with chronic aortic dissection type b

verfasst von: Tim F. Weber, Maria-Katharina Ganten, Dittmar Böckler, Philipp Geisbüsch, Annette Kopp-Schneider, Hans-Ulrich Kauczor, Hendrik von Tengg-Kobligk

Erschienen in: European Radiology | Ausgabe 1/2009

Einloggen, um Zugang zu erhalten

Abstract

To characterize the heartbeat-related distension of dissected and non-dissected thoracic aortic segments in chronic aortic dissection type b (CADB) ECG-gated computed tomography angiography was performed in ten CADB patients. For 20 time points of the R–R interval, multiplanar reformations were taken at non-dissected (A, B) and dissected (C) aorta: ascending aorta (A), aortic vertex (B), 10 cm distal to left subclavian (Ct, true channel; Cf, false channel). Relative amplitudes of aortic area and major and minor axis diameter changes were quantified. Area amplitudes were 12.9 ± 3.7%, 11.4 ± 1.8%, 16.5 ± 5.9% and 10.5 ± 5.7% at A, B, Ct and Cf, respectively. Area amplitudes were significantly greater at Ct than at Cf and B (p < 0.05). Major axis diameter amplitudes were 7.7 ± 1.9%, 6.2 ± 1.3%, 5.9 ± 2.0% and 6.1 ± 3.6% at A, B, Ct and Cf, respectively. There were no differences in major axis diameter amplitudes. Minor axis diameter amplitudes were 6.7 ± 2.1%, 8.4 ± 1.9%, 12.7 ± 6.3% and 6.0 ± 2.2% at A, B, Ct and Cf, respectively. Minor axis diameter amplitudes were significantly the greatest at Ct (p < 0.05). In CADB, the heartbeat-related distension of aortic area and diameter is evenly distributed over the non-dissected aortic arch. As a result from different blood flow properties, there are significantly greater conformational changes in the true channel of the dissected aorta.

Meszaros I, Morocz J, Szlavi J et al (2000) Epidemiology and clinicopathology of aortic dissection. Chest 117:1271–1278PubMedCrossRef

Gleason TG (2005) Heritable disorders predisposing to aortic dissection. Semin Thorac Cardiovasc Surg 17:274–281PubMedCrossRef

Shennan T (1934) Dissecting aneurysms special report. Medical Research Council, London

Spittell PC, Spittell JA Jr, Joyce JW et al (1993) Clinical features and differential diagnosis of aortic dissection: experience with 236 cases (1980 through 1990). Mayo Clin Proc 68:642–651PubMed

Coselli JS, de Figueiredo LF (1997) Natural history of descending and thoracoabdominal aortic aneurysms. J Card Surg 12:285–289 discussion 289–291PubMed

Hagan PG, Nienaber CA, Isselbacher EM et al (2000) The international registry of acute aortic dissection (IRAD): new insights into an old disease. JAMA 283:897–903PubMedCrossRef

McGee EC Jr, Pham DT, Gleason TG (2005) Chronic descending aortic dissections. Semin Thorac Cardiovasc Surg 17:262–267PubMedCrossRef

Ince H, Nienaber CA (2007) Etiology, pathogenesis and management of thoracic aortic aneurysm. Nat Clin Pract Cardiovasc Med 4:418–427PubMedCrossRef

Schumacher H, Böckler D, Allenberg JR (2004) Surgical management of thoracic aortic lesions. Aneurysm, dissection and traumatic rupture. Chirurg 75:937–958PubMedCrossRef

10.

Winnerkvist A, Lockowandt U, Rasmussen E et al (2006) A prospective study of medically treated acute type B aortic dissection. Eur J Vasc Endovasc Surg 32:349–355PubMedCrossRef

11.

Czermak BV, Waldenberger P, Fraedrich G et al (2000) Treatment of Stanford type B aortic dissection with stent-grafts: preliminary results. Radiology 217:544–550PubMed

12.

Lopera J, Patino JH, Urbina C et al (2003) Endovascular treatment of complicated type-B aortic dissection with stent-grafts: midterm results. J Vasc Interv Radiol 14:195–203PubMed

13.

Riesenman PJ, Farber MA, Mendes RR et al (2005) Endovascular repair of lesions involving the descending thoracic aorta. J Vasc Surg 42:1063–1074PubMedCrossRef

14.

Stone DH, Brewster DC, Kwolek CJ et al (2006) Stent-graft versus open-surgical repair of the thoracic aorta: mid-term results. J Vasc Surg 44:1188–1197PubMedCrossRef

15.

Böckler D, Schumacher H, Ganten M et al (2006) Complications after endovascular repair of acute symptomatic and chronic expanding Stanford type B aortic dissections. J Thorac Cardiovasc Surg 132:361–368PubMedCrossRef

16.

Thurnher SA, Grabenwoger M (2002) Endovascular treatment of thoracic aortic aneurysms: a review. Eur Radiol 12:1370–1387PubMedCrossRef

17.

Fattori R, Napoli G, Lovato L et al (2003) Descending thoracic aortic diseases: stent-graft repair. Radiology 229:176–183PubMedCrossRef

18.

Di Tommaso L, Monaco M, Mottola M et al (2006) Major complications following endovascular surgery of descending thoracic aorta. Interact Cardiovasc Thorac Surg 5:705–708PubMedCrossRef

19.

Nienaber CA, Kische S, Ince H (2007) Thoracic aortic stent-graft devices: problems, failure modes, and applicability. Semin Vasc Surg 20:81–89PubMedCrossRef

20.

Weigel S, Tombach B, Maintz D et al (2003) Thoracic aortic stent graft: comparison of contrast-enhanced MR angiography and CT angiography in the follow-up: initial results. Eur Radiol 13:1628–1634PubMedCrossRef

21.

Willoteaux S, Lions C, Gaxotte V et al (2004) Imaging of aortic dissection by helical computed tomography (CT). Eur Radiol 14:1999–2008PubMedCrossRef

22.

Böckler D, Hylik-Dürr A, von Tengg-Kobligk H et al (2007) Clinical requirements of aortic imaging. Radiologe 47:962–973PubMedCrossRef

23.

Huber A, Matzko M, Wintersperger BJ et al (2001) Reconstruction methods in postprocessing of CT- and MR-angiography of the aorta. Radiologe 41:689–694PubMedCrossRef

24.

Parker MV, O’Donnell SD, Chang AS et al (2005) What imaging studies are necessary for abdominal aortic endograft sizing? A prospective blinded study using conventional computed tomography, aortography, and three-dimensional computed tomography. J Vasc Surg 41:199–205PubMedCrossRef

25.

Ganten M, Boese JM, Leitermann D et al (2005) Quantification of aortic elasticity: development and experimental validation of a method using computed tomography. Eur Radiol 15:2506–2512PubMedCrossRef

26.

Ganten M, Krautter U, Hosch W et al (2007) Age related changes of human aortic distensibility: evaluation with ECG-gated CT. Eur Radiol 17:701–708PubMedCrossRef

27.

Ganten M, von Tengg-Kobligk H, Weber TF et al (2008) Charakterisierung der Membranbewegung bei Patienten mit chronischer B-Dissektion mittels EKG-getriggerter CT. Rofo 180:S157

28.

Muhs BE, Vincken KL, van Prehn J et al (2006) Dynamic cine-CT angiography for the evaluation of the thoracic aorta; insight in dynamic changes with implications for thoracic endograft treatment. Eur J Vasc Endovasc Surg 32:532–536PubMedCrossRef

29.

van Prehn J, Vincken KL, Muhs BE et al (2007) Toward endografting of the ascending aorta: insight into dynamics using dynamic cine-CTA. J Endovasc Ther 14:551–560PubMedCrossRef

30.

Herold U, Piotrowski J, Baumgart D et al (2002) Endoluminal stent graft repair for acute and chronic type B aortic dissection and atherosclerotic aneurysm of the thoracic aorta: an interdisciplinary task. Eur J Cardiothorac Surg 22:891–897PubMedCrossRef

31.

Sternbergh WC 3rd, Money SR, Greenberg RK et al (2004) Influence of endograft oversizing on device migration, endoleak, aneurysm shrinkage, and aortic neck dilation: results from the Zenith Multicenter Trial. J Vasc Surg 39:20–26PubMedCrossRef

32.

Mohan IV, Laheij RJ, Harris PL (2001) Risk factors for endoleak and the evidence for stent-graft oversizing in patients undergoing endovascular aneurysm repair. Eur J Vasc Endovasc Surg 21:344–349PubMedCrossRef

33.

Shimono T, Kato N, Yasuda F et al (2002) Transluminal stent-graft placements for the treatments of acute onset and chronic aortic dissections. Circulation 106:I241–247PubMed

34.

Schumacher H, Von Tengg-Kobligk H, Ostovic M et al (2006) Hybrid aortic procedures for endoluminal arch replacement in thoracic aneurysms and type B dissections. J Cardiovasc Surg (Torino) 47:509–517

35.

Chang JM, Friese K, Caputo GR et al (1991) MR measurement of blood flow in the true and false channel in chronic aortic dissection. J Comput Assist Tomogr 15:418–423PubMedCrossRef

36.

Inoue T, Watanabe S, Sakurada H et al (2000) Evaluation of flow volume and flow patterns in the patent false lumen of chronic aortic dissections using velocity-encoded cine magnetic resonance imaging. Jpn Circ J 64:760–764PubMedCrossRef

37.

Markl M, Draney MT, Hope MD et al (2004) Time-resolved 3-dimensional velocity mapping in the thoracic aorta: visualization of 3-directional blood flow patterns in healthy volunteers and patients. J Comput Assist Tomogr 28:459–468PubMedCrossRef

38.

Xu SD, Huang FJ, Du JH et al (2008) A study of aortic dimension in type B aortic dissection. Interact Cardiovasc Thorac Surg 7(2):244–8 Epub 2008 Jan 10PubMedCrossRef

39.

Kortesniemi M, Kiljunen T, Kangasmaki A (2006) Radiation exposure in body computed tomography examinations of trauma patients. Phys Med Biol 51:3269–3282PubMedCrossRef

40.

Gray JE, Archer BR, Butler PF et al (2005) Reference values for diagnostic radiology: application and impact. Radiology 235:354–358PubMedCrossRef

41.

Duvernoy O, Coulden R, Ytterberg C (1995) Aortic motion: a potential pitfall in CT imaging of dissection in the ascending aorta. J Comput Assist Tomogr 19:569–572PubMedCrossRef

42.

Beller CJ, Labrosse MR, Thubrikar MJ et al (2004) Role of aortic root motion in the pathogenesis of aortic dissection. Circulation 109:763–769PubMedCrossRef

Titel: Assessment of thoracic aortic conformational changes by four-dimensional computed tomography angiography in patients with chronic aortic dissection type b
verfasst von: Tim F. Weber
Maria-Katharina Ganten
Dittmar Böckler
Philipp Geisbüsch
Annette Kopp-Schneider
Hans-Ulrich Kauczor
Hendrik von Tengg-Kobligk
Publikationsdatum: 01.01.2009
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 1/2009
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-008-1103-x

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Assessment of thoracic aortic conformational changes by four-dimensional computed tomography angiography in patients with chronic aortic dissection type b

Abstract

Neu im Fachgebiet Radiologie

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Update Radiologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2009

2D and 3D T2-weighted MR sequences for the assessment of neurovascular bundle changes after nerve-sparing radical retropubic prostatectomy with erectile function correlation

Use of dynamic CT in acute respiratory distress syndrome (ARDS) with comparison of positive and negative pressure ventilation

Pediatric liver tumors – a pictorial review

Perfusion characteristics of late radiation injury of parotid glands: quantitative evaluation with dynamic contrast-enhanced MRI

Multidetector CT angiography in the evaluation of acute mesenteric ischemia

Enterclysis versus enterography: the unsettled issue

Neu im Fachgebiet Radiologie

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Update Radiologie