Helical (spiral) CT in the evaluation of emergent thoracic aortic syndromes - Traumatic aortic rupture, aortic aneurysm, aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer

Catheter angiography traditionally has been the gold standard for evaluating emergent aortic syndromes. With advances in MR imaging, color Doppler ultrasound, and CT, newer, noninvasive ways of evaluating the thoracic and abdominal aorta have emerged. Each of these modalities has strengths and weaknesses, but CT plays the dominant and critical role in the evaluation of patients presenting with emergent aortic syndromes. This article focuses on the use of helical CT in the evaluation of traumatic aortic rupture, thoracic aortic aneurysm, aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer. For each entity, the pathophysiology, CT technique, and characteristic CT findings are discussed.