Learning objectives
To review the detailed anatomy of the aorta.
To revise the different entities that may affect each tunica of the aorta.
To explain its ethiopathogenesis and different imaging findings.
To illustrate the key imaging features that will help the radiologist to make an adequate diagnosis.
Background
The aorta is composed of 3 layers:
TUNICA INTIMA: Composed of endothelial cells and a layer of loose connective tissue.
The internal elastic lamina separates the tunica intima from the tunica media.
TUNICA MEDIA:Is a strong muscular layer,
being the greater part of the aortic wall.
It is formed by the elastic lamellae mixed with circularly arranged smooth muscle fibers.
TUNICA ADVENTITIA: Formed byloose connective tissue with collagen,
fibroblasts and macrophages.
Various diseases can affect the aorta wall,
but usually they tend to predominate in...
Findings and procedure details
A) ENTITIES THAT PRIMARILY AFFECT TUNICA INTIMA
1.
MID-AORTIC SYNDROME
Rare aortic coarctation that occurs in children.
Frequently involves the renal arteries.
Itsethiopathogenesis is discussed.
Hystologically is due to distorsion and fibrosis of intimal and elastic internal lamina
Idiopathic type: good prognosis.
2ry type: associated with Takayasu arteritis and Williams syndrome.
ULTRASOUND:
- Parvus-tardus doppler waveform
- Diminished RI
ANGIOGRAPHY:
- Segmental abdominal aorta stenosis
- Renal artery stenosis
2.
PENETRATING ULCER
In patients with advanced atherosclerosis.
Most common in descending thoracic aorta.
Ethiopathogenesis: Deep...
Conclusion
There is a variety of abnormal conditions that may affect the aorta,
traditionally classified by its ethiology or clinical presentation.
We propose a new classification for aortic pathology based on histological findings,illustrating what layer is predominantly affected on each entity.
Knowledge of the underlying ethiopathogenesis in aortic diseases is necessary to establish an adequate correlation with the radiologic findings in each imaging technique.
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