Thoracic aorta imaging with multisclice CT

The development of multislice CT (MSCT) technology has revolutionized the ability to image the thoracic aorta noninvasively. MSCT allows scanning with greater speed and narrower collimation compared with single-detector helical CT systems, which translates to larger volumes of coverage with improved spatial resolution [1]. The promise of isotropic voxel imaging may be realized with MSCT, and should dramatically improve the quality of the acquired datasets and provide very high quality image postprocessing. Multislice CT aortography (MSCTA) possesses several advantages over other modalities frequently used to investigate thoracic aortic disease, such as transesophageal echocardiography (TEE), MR imaging, and aortography. The speed and ease of MSCT make it the examination of choice for acute aortic pathologies, such as dissection, intramural hematoma (IMH), aneurysm, and acute traumatic injury. MSCT is less operator-dependent than TEE [2] and is easier and faster to perform than either MR imaging or aortography. These considerations are particularly advantageous in acutely ill patients. Another benefit of MSCT that these other methods do not enjoy is the ability effectively to image other thoracic organs, especially the lung parenchyma and pleural space. This is particularly important because cardiovascular abnormalities frequently present with nonspecific symptoms, and nonvascular etiologies of the patient's presentation may be obvious with CT Finally, the volumetric data obtained with MSCTA is readily processed using two-dimensional, three-dimensional, or volume-rendering techniques to provide angiogram-like images or images in any desired plane or obliquity. As more radiology practices adopt multislice scanners, MSCT will replace single-detector helical CT as the imaging modality of choice for the investigation of acute aortic syndromes.