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Congress: ECR24
Poster Number: C-21769
Type: EPOS Radiologist (educational)
DOI: 10.26044/ecr2024/C-21769
Authorblock: V. Valcheva, M. Nedevska, V. V. Groudeva, E. Mihaylova, S. Karaibraimov, D. T. Dimitrova; Sofia/BG
Disclosures:
Veronika Valcheva: Nothing to disclose
Maria Nedevska: Nothing to disclose
Violeta Vassileva Groudeva: Nothing to disclose
Evgeniya Mihaylova: Nothing to disclose
Shefket Karaibraimov: Nothing to disclose
Diana Tihomirova Dimitrova: Nothing to disclose
Keywords: Arteries / Aorta, Cardiovascular system, CT, CT-Angiography, Contrast agent-intravenous, Grafts, Prostheses
Learning objectives 1. To distinguish the normal postoperative appearance of the aorta from the possible post-treatment complications.2. To present the role of non-contrast and contrast-enhanced multidetector computed tomography (MDCT) for the evaluation of the operated aorta.
Read more Background A large number of diseases can affect the aortic wall of the thoracic and abdominal aorta. Some of them include aortic dissection, intramural hematoma, penetrating aortic ulcer, aneurysms. To properly evaluate postoperative imaging of the aorta it is essential to understand the anatomy, different repair techniques, normal and pathological findings. The thoracic aorta is divided into three sections: the ascending aorta (extends from the aortic valve to the level of the brachiocephalic trunk), the aortic arch (extends from the level...
Read more Findings and procedure details MDCT and in particular multidetector computed tomographic angiography (MDCTA) is the first choice imaging modality for evaluation of the aorta. It is important to use a high flow of intravenous contrast and contrast material with high iodine content to ensure high quality results of the exam. For diagnosis of complications such as leaking, hemorrhage, graft infection, pseudoaneurysm, post-contrast images are mandatory. On the other hand, non-contrast images are important for differentiation of the hyperdense grafts and their morphology in comparison...
Read more Conclusion Evaluation of the postoperative aorta can be a diagnostic dilemma even for an experienced radiologist. The radiologist has to be familiar with different aortic repair techniques and used surgical components to distinguish the normal appearance of the post-treatment aorta and the presence of complications. MDCT and specifically MDCTA plays a crucial role in the detection of post-treatment complications and in the routine follow-up of all patients who have undergone aortic interventions.
Read more References Hoang, J. K., Martinez, S., & Hurwitz, L. M. (2009). MDCT Angiography of Thoracic Aorta Endovascular Stent-Grafts: Pearls and Pitfalls. American Journal of Roentgenology, 192(2), 515-524. https://doi.org/10.2214/ajr.08.1365  Marquis, K. M., Naeem, M., Rajput, M. Z., Raptis, D. A., Steinbrecher, K. L., Ohman, J. W., Bhalla, S., & Raptis, C. A. (2021). CT of Postoperative Repair of the Ascending Aorta and Aortic Arch. RadioGraphics, 41(5), 1300-1320. https://doi.org/10.1148/rg.2021210026  Li W, Rongthong S, Prabhakar AM, Hedgire S. Postoperative imaging of the aorta. Cardiovasc Diagn Ther....
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