Cardiology Clinics Of North America: Volume 17, #4
Urban Bruce A., Bluemke David A., Johnson Kevin M., Fishman Elliot K.
Historically, the depiction of thoracic aortic disease has been limited to conventional angiography. Although long considered to be the "gold-standard" of vascular imaging, conventional angiography is relatively invasive, time-consuming, and costly. Over the last two decades, marked advances have been made in the noninvasive imaging techniques, in many cases making conventional angiography an obsolete procedure for the detection, diagnosis, and display of the aorta and aortic pathology. Computed tomography (CT), magnetic resonance (MR) imaging, and transesophageal echocardiography (TEE) represent three outstanding, commonly available noninvasive modalities for imaging the thoracic aorta. The purpose of this article is to: 1) describe the protocols and techniques for each imaging modality; 2) demonstrate the imaging appearance of commonly encountered vascular pathologies of the thoracic aorta, including aortic aneurysms and aortic dissections; and 3) discuss the advantages and disadvantages of these modalities.