MDCT angiography of the thoracic aorta

Multidetector computed tomography angiography (MDCTA) is a nonivasive and accurate technique for assessment of many thoracic aortic abnormalities. It offers several advantages over conventional aortography for evaluation of the thoracic aorta. State-of-the-art MDCT scanners, with improved temporal and isotropic resolution, enable volumetric acquisition that provides clear anatomic delineation of thoracic aorta, its tortuous branches, and adjacent aneurysms and pseudo aneurysms. In contrast with the projectional technique of conventional aortography, these frequently overlapping structures can affect visualization and delineation of anatomic relationships. In addition, MDCTA allows simultaneous delineation of true and false luminal flow channels in thoracic aortic dissections, intramural hematomas communicating with the aortic lumen, slow perigraft blood flow around aortic stent grafts, as well as direct visualization of the aortic wall and noncommunicating intramural hematomas. This chapter reviews techniques for acquisition and interpretation of thoracic aortic MDCTA and describes abnormalities in which MDCTA provides valuable information.