chapter  24
14 Pages

Computed Tomographic Angiography of the Thoracic Aorta

ByBrad Thompson, Edwin J R van Beek

Diseases that affect the thoracic aorta are commonly associ-

ated with high rates of mortality, with many requiring some

form of immediate surgical intervention. Understandably,

there is a critical need for establishing an immediate and

accurate clinical diagnosis of suspected aortic disease at the

time of presentation. There are several modalities that can

be used in the radiographic evaluation of the thoracic aorta,

namely angiography, magnetic resonance imaging (MR),

and computed tomography (CT). Deciding which one to

use, however, largely depends on a host of factors dependent

upon the scenario and clinical suspicion as well as availabil-

ity, convenience, patient stability, and of course total exam

time. For example, angiography, long considered to be the

gold standard in aortic imaging, appears to be best suited in

the setting of trauma, but is invasive, potentially inconven-

ient, and lengthy, which may delay definitive treatment.