CHRONIC AORTIC DISSECTION - COMPARISON OF MR-IMAGING AND TRANSESOPHAGEAL ECHOCARDIOGRAPHY

PURPOSE: To compare the diagnostic value of magnetic resonance (MR) imaging and transesophageal echocardiography (TEE) in the follow-up of chronic dissection of the thoracic aorta. MATERIALS AND METHODS: Follow-up MR imaging and TEE were performed in 25 consecutive patients with aortic dissection. Ten patients had a type I dissection and 15 had a type III dissection. All patients with type I dissection underwent surgical intervention. Ten of 15 type III dissections were managed medically, and five were managed with surgical intervention. RESULTS: Identification of a persisting dissection and differentiation of the true and false lumina were equal with both methods. The arch vessels and all anastomoses in the surgically treated patients could be assessed only with MR imaging. An intimal flap in the aortic root and formation of an aortic thrombus were visualized in more detail with TEE. At least one entry site could be detected with both methods in 86% of the patients. TEE demonstrated small entry sites more frequently. CONCLUSION: MR imaging provides better visualization of anastomoses and easier comparison of serial studies; TEE should be employed if MR findings are equivocal.