- To review the pathophysiological characteristics and complications of aortic emergencies.
- To describe and illustrate the most typical imaging findings of aortic emergencies (including their potential pitfalls) that allows the differential diagnosis between them in order to make the most accurate diagnosis.
- To demonstrate the importance of imaging in choosing the most appropriate therapeutic approach and in the suspicion of complications that may arise from it.
Acute Aortic Syndromes (AAS) are a set of acute,
emergent aortic pathologies that,
due to their clinical characteristics,
risk factors and similar prognosis,
were included in this common category.
Because they are clinically indistinguishable,
imaging plays an essential role in differentiating each of these syndromes and in establishing an accurate and rapid diagnosis.
AAS include aortic dissection,
intra-mural hematoma (IMH) and penetrating atherosclerotic ulcer (PAU).
Although they originate in different pathophysiological processes,
they can evolve from one entity to another.
The typical clinical presentation...
Findings and procedure details
Aortic dissection is the most common acute aortic emergency.
If left untreated it is often fatal.
Dissection occurs when there is a tear in the intima,
allowing blood to enter into the vessel wall.
This parietal blood extends longitudinally and circumferentially,
progressively detaching the intima from the media and creating an intima-media flap,
which separates the true lumen from the false intraparietal lumen.
The most common sites of the intima’s lesion are in the ascending aorta,
most often in the right wall,
Aortic emergencies are potentially life-threatening and not infrequent situations.
Contrast-enhanced CT has an essential role,
being considered the first-line diagnostic examination,
allowing a fast and accurate diagnosis and therapeutic planning,
which can improve the prognosis of these patients.
It is essential for any Radiologist to know the main imaging findings of these situations.
Acute aortic syndrome: CT ﬁndings.
CT and MRI of the Whole Body.
Computed Body Tomography with MRI Correlation.
Lippincott Williams & Wilkins.
Acute aortic syndrome: differential diagnosis in emergency department.
European Congress Radiology.