Dual-source CT For The Tears Of Thoracic Aortic Dissections Assessment:A Controlled Trial

Early and accurate diagnosis and decision making regarding surgical or conservative intervention are essential to reduce morbidity and mortality among patients with clinically thoracic aortic dissection(TAD), expecially confirming the tears of TAD. Imaging techniques including transthoracic echocardiography(TTE), multi-slice spiral computed tomography(MSCT), magnetic resonance imaging(MRI) and invasive digital subtraction angiography(DSA); However, capabilities of the 4 imaging techniques were found to be differences for confirming or excluding the tears of TAD. The next generation of imaging technology, dual-source CT(DSCT), offers many advantages over conventional CT: temporal resolution is improved; motion artifacts are minimal; scanning is more rapid; examination time is substantially shorter. DSCT cardiac imaging have shown a robust image quality and a very good diagnostic accuracy of coronary CT angiography. Then patients with TAD were examined by DSCT in this controlled trial to assess the clinical application value of DSCT.Methods: From January to October of 2008, 139 consecutive patients with suspected TAD were enrolled in this trial by comparing DSCT with other imaging modalities including DSA, TTE, 64-MSCT and MRI.Results: Ninety-seven patients were diagnosed TAD. The samples of DSCT, DSA, TTE, MSCT and MRI were 112, 72, 94, 60 and 6, respectively. The diagnosis sensitivity were 95% for TTE(P<0.05), 93% for MSCT(P<0.05), 100% for DSCT, DSA and MRI. The diagnostic accuracy for preoperative revealing of the tears of TAD of DSCT, DSA, TTE and MSCT were 98%, 98%, 46% (P<0.05) and 87%(P<0.05). Compare with DSCT, these differences had significances.Conclusion: The diagnostic accuracy of DSCT for preoperative revealing of the tears of TAD is higher than DSA, TTE, MSCT or MRI. This is good as the primary checking option of imaging modalities.