The Application Of Aortic Angiography With MSCTA And Comparative Study With DSA On Aortic Dissection

Objective: To investigate the application of aortic angiography with multi-slices CT angiography (MSCTA) on aortic dissection .To determine the value of the three-dimensional(3D) reconstruction imaging in detecting of tear entry, the extent of intimal flap, and the true and false channel of dissection .To compare imaging features before endoluminal stentgrafting with DSA.Method and Material: Forty-nine patients with aortic diseases were evaluated in this study with multi-slices CT scanner.3D reconstruction techniques including volume rendering (VR), maximum intemsity projection(MIP), multi-plane reformation(MPR), curvedp lanarre formaiton(CPR) were adopted. The demonstration rate of each reconstruction on tear entry, the extent of intimal flap, and the true and false channel of dissection was calculated. We measured position and size of the first tears of intimal, the biggest diameter of artery at basic left subclavia artery, the distant between the first tears and left subclavia artery, the diameter of true or false lumen to identify difference between MSCTA and DSA before endoluminal stentgrafting on thirty patients with Debakey III aortic dissection .Results: The demonstration rate of MPR,CPR,VR on tear entry was 95.92%,95.92%,18.37%, respectively. And for intimal flap was 100% respectively. MIP didn't demonstrate the tear entry and intimal flap. The demonstration rate of MPR,CPR,VR on the true and false channel was 100% respectively, and MIP was 67.35%.There is obvious difference in measureing position and quantity of the tears of intimal between MSCTA and DSA(P<0.05), there is not difference in measureing the biggest diameter of aorta at basic left subclavia artery and the diameter of true or false lumen between MSCTA and DSA(P>0.05). We found other diseases in MSCTA image excessively.Conclusion: MSCTA can well display the aortic dissection and the row data was suitable for 3D postprocessing. MPR and CPR are superior to MIP. Exact measures in aortic dissection's parameter not only help but also guide endoluminal stentgrafting, which can be regarded as the first selection of imaging technology in dignosis and valuing endoluminal stentgrafting before operation.