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The International Journal of Cardiovascular Imaging

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01.01.2014 | Original Paper

The role of contrast enhanced transesophageal echocardiography in the diagnosis and in the morphological and functional characterization of acute aortic syndromes

verfasst von: Eustachio Agricola, Massimo Slavich, Luca Bertoglio, Andrea Fisicaro, Michele Oppizzi, Enrico Marone, Germano Melissano, Vincenzo Tufaro, Alberto Margonato, Roberto Chiesa

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 1/2014

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Abstract

The aim of this study is to evaluate the role of contrast transesophageal echocardiography (cTEE) in the diagnostic characterization of acute aortic syndromes (AAS) [aortic dissection, intramural hematoma, penetrating ulcer]. We enrolled 66 non-consecutive patients with clinical suspicion of AAS. Standard transesophageal echocardiography and cTEE were performed prior to gated-CT angiography, which has been assumed as reference standard. cTEE was obtained with a single bolus of contrast agent injection. The definitive diagnosis of AAS was made in 48 patients by gated-CT angiography: 22 aortic dissections, 15 intramural hematomas and 11 penetrating aortic ulcers. Standard TEE and cTEE correctly diagnosed AAS in 87 and 100 % (P = 0.03) cases respectively. Standard TEE correctly diagnosed aortic dissection in 20/22 (91 %) and cTEE in 22/22 (100 %) (P = 0.5) cases. cTEE was superior than standard TEE in the visualization of false lumen entry tear (22/22 vs. 16/22, P = 0.03). Standard TEE correctly diagnosed intramural hematoma in 11/15 and cTEE 15/15 (P = 0.12) cases. Microtears were identified in 3 patients by cTEE an in 1 patient by standard TEE (P = 0.4). The presence of focal contrast enhancement was identified in 4 and 0 patients by cTEE and standard TEE respectively (P = 0.06). Both standard and cTEE correctly diagnosed penetrating aortic ulcer in 11/11 (100 %) (P = 1.0) cases. cTEE provides additional value over standard TEE in the diagnosis and in the anatomic and functional characterization of AAS.

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Titel: The role of contrast enhanced transesophageal echocardiography in the diagnosis and in the morphological and functional characterization of acute aortic syndromes
verfasst von: Eustachio Agricola
Massimo Slavich
Luca Bertoglio
Andrea Fisicaro
Michele Oppizzi
Enrico Marone
Germano Melissano
Vincenzo Tufaro
Alberto Margonato
Roberto Chiesa
Publikationsdatum: 01.01.2014
Verlag: Springer Netherlands
Erschienen in: The International Journal of Cardiovascular Imaging / Ausgabe 1/2014
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-013-0290-y

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