THORACIC AORTIC DISSECTION - DIAGNOSIS WITH TRANSESOPHAGEAL ECHOCARDIOGRAPHY VERSUS MR-IMAGING

PURPOSE: To compare transesophageal echocardiography (TEE) and magneti c resonance (MR) imaging in the diagnosis of dissection of the thoraci c aorta. MATERIALS AND METHODS: Thirty-one consecutive patients with c linically suspected aortic dissection and 10 postoperative patients un derwent transesophageal color Doppler echocardiography and MR imaging. Imaging results were compared at independent double-blind readings. F inal diagnosis was obtained from consensual review of all corroborativ e studies. RESULTS: MR imaging depicted the intimal flap in 95% of aor tic dissections; TEE, in 86% (P < .05). In surgical patients, the sens itivity of MR in detection of residual dissection was 100% versus 86% with TEE (P < .05). The inferior extent of the dissected lumen was see n only with MR imaging. False-positive results occurred in two cases w ith TEE and in one with MR imaging. CONCLUSION: MR imaging is superior to TEE in the evaluation and follow-up of dissection of the thoracic aorta. Because the availability of MR is limited, however, TEE should remain the standard modality for diagnosis.