Electron beam tomography with three-dimensional reconstruction in the diagnosis of aortic diseases

Background. This study was performed to evaluate the protocols of electron beam tomographic angiography and three-dimensional reconstruction for asses sing the diagnostic value of aortic diseases, Methods. Experimental design: Retrospective and comparative study, Settings : University hospital. Patients: Between 1996 and 1998, 189 eases who under went electron beam tomographic angiography and diagnosed with aortic diseas es were analyzed retrospectively. The results were compared with surgical a nd pathological findings in 68 cases. Electron beam tomographic angiography was used single-slice-scanning with EGG-triggering for screening of the th oracic aorta, continuous-volume-scanning, permitted by continuous X-ray exp osure with table incremention, was performed for the abdominal aorta scanni ng without EGG-triggering. Three-dimensional reconstructions were performed with shaded-surface display, multiplanar reformatting and/or maximum inten sity projection methods, Results. Electron beam tomography angiography with EGG-triggered sections o f single-slice-scanning improved the image quality of the ascending aorta w ithout motion artifacts. Continuous-volume-scanning was suitable for screen ing of the abdominal aorta because of minimizing exposure time (10-14 sec) and saving contrast media (total contrast material of 45.5+/-6.6 ml was nee ded), One hundred eighty-nine cases were diagnosed with aortic dissection ( 97 cases), aortic aneurysm (26 cases), pseudoaneurysm (8 cases), Marfan's s yndrome (39 cases), Takayasu's arteritis (5 cases) and congenital aortic ma lformations (14 cases). Electron beam tomography results were compared with the findings of surgery (as gold standard) in 68 cases, the diagnostic acc uracy was 97% (2 cases with aortic aneurysm were erroneously diagnosed with pseudoaneurysm), Conclusions. Electrocardiographically triggered, contrast-enhanced electron beam tomography is feasible for the diagnosis of all kinds of aortic disea ses, with excellent three-dimensional images competitive in quality with co nventional selective aortic angiography or digital subtraction angiography.