Noritaka Kamei, Presenter: Nothing to Disclose

Norio Hongo, Abstract Co-Author: Nothing to Disclose

Shinji Miyamoto, Abstract Co-Author: Nothing to Disclose

Rieko Shuto MD, Abstract Co-Author: Nothing to Disclose

Shunro Matsumoto MD, Abstract Co-Author: Nothing to Disclose

Satomi Ide, Abstract Co-Author: Nothing to Disclose

Mika Okahara MD, Abstract Co-Author: Nothing to Disclose

Shinya Ueda, Abstract Co-Author: Nothing to Disclose

Hiro Kiyosue MD, Abstract Co-Author: Nothing to Disclose

Hiromu Mori MD, Abstract Co-Author: Nothing to Disclose

Our purpose is to assess the 4D data acquired from retrospective electrocardiographically(ECG) gated computed tomography(CT)  using cine multiplanar reformation(cine MPR), and to characterize and define the kinetics of the intimal flap in acute or chronic aortic dissections.  

Twenty eight consecutive cases with Debakey III aortic dissection without prominent intramural thrombus  who underwent ECG-gated CT from January 2010 to September 2013 were included in this study. Each CT scan was retrospectively reconstructed into sequential 10 axial datasets. Cine cross-sectional MPR images of the whole descending aorta were created. The maximum(Dmax) and minimum(Dmin) diameter of the true lumen at all time points was measured at each anatomic level. Maximum diameter change was calculated using following formula (Dmax-Dmin)/Dmax.

The Dmax in the proximal descending aorta reached its peak in early systole. There was a gradual and delayed wavelike movement of the peak toward the distal abdominal aorta. Dmax in the lower abdominal aorta was seen in diastolic phase. In an acute dissection group, the maximum diameter change, with collapse of the true lumen, was most frequently seen at the level of third lumbar vertebral body in systole. That was more prominent in the cases having no re-entry lower than the level of third lumbar spine, which included two cases with limb ischemia. There was less motion of the intimal in the chronic group than in the acute group.   

Assessments of cine MPR images of the whole descending aorta acquired by ECG-gated CT revealed the complicated dynamic movement of the intimal flap in acute and chronic aoric dissections.

This reserch addresses the unknown dynamic behavior of the septum in acute and chronic aortic dissections. The assessment of the motion of the intimal flap and the location of the re-entry described using CT may inform our clinical management of patients with Debakey III dissection.

Kamei, N, Hongo, N, Miyamoto, S, Shuto, R, Matsumoto, S, Ide, S, Okahara, M, Ueda, S, Kiyosue, H, Mori, H, Kinetic Assessment of the Intimal Flap in Acute or Chronic Aortic Dissection Using Cne CPR and MPR Images Acquired by ECG-gated CT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013531.html