AORTIC DISSECTION - A COMPARATIVE-STUDY OF DIAGNOSIS WITH SPIRAL CT, MULTIPLANAR TRANSESOPHAGEAL ECHOCARDIOGRAPHY, AND MR-IMAGING

PURPOSE: To compare the usefulness of spiral computed tomography (CT), multiplanar transesophageal echocardiography (TEE), and magnetic reso nance (MR) imaging in the diagnosis of thoracic aortic dissection and arch vessel involvement.MATERIALS AND METHODS: Forty-nine symptomatic patients with clinically suspected aortic dissection were examined wit h contrast material-enhanced spiral CT, multiplanar TEE, and 0.5-T MR imaging (T1-weighted, cardiac-gated, spin-echo sequences). Imaging res ults were confirmed at autopsy (five patients), intraoperative explora tion (23 patients), angiography (nine patients), and follow-up (12 pat ients). RESULTS: Sensitivity in the detection of thoracic aortic disse ction was 100% for all techniques. Specificity was 100%, 94%, and 94% for spiral CT, multiplanar TEE, and MR imaging, respectively. In the a ssessment of aortic arch vessel involvement sensitivity was 93%, 60%, and 67%, respectively, and specificity was 97%, 85%, and 88%, respecti vely. CONCLUSION: Spiral CT and multiplanar TEE are as valuable as MR imaging in the detection of thoracic aortic dissection. In the assessm ent of the supraaortic branches, spiral CT is superior (P < .05).