Email this article MULTIDETECTOR COMPUTED TOMOGRAPHY FOR IDENTIFICATION OF INSTABILITY OF AORTIC ANEURYSM WALL
- Authors: Vishnyakova Jr. M.V.1, Lar’kov R.N.1, Vishnyakova M.V.1, Osiev A.G.1
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Affiliations:
- Moscow Regional Research and Clinical Institute (MONIKI)
- Issue: No 38 (2015)
- Pages: 27-33
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/265
- DOI: https://doi.org/10.18786/2072-0505-2015-38-27-33
- ID: 265
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Abstract
Background: Aortic aneurysm is characterized by high incidence, polymorphic clinical features and sudden onset of severe complications.
Aim: To develop a standard multidetector computed tomography (MDCT) protocol for aortic aneurysm examination and image analysis for detection the signs of aortic wall instability.
Materials and methods: The data of 279 patients with aortic aneurysm who underwent MDCT examination during 2009–2014 was analyzed to identify aortic wall instability signs.
Results: Complicated course of aortic aneurysm was observed in 100 cases (36%). The most common sign of aortic wall instability was aortic dissection. According to our results, a new definition of aortic aneurysm complications was elaborated. It included signs of aortic wall instability with incomplete and/or complete disruption of aortic wall layers. A scheme of the most common patterns of aortic wall abnormalities was proposed, allowing a radiologist to reach high accuracy in characterizing this pathology.
Conclusion: A dedicated MDCT protocol for aortic aneurysm detection and image analysis can increase quality of radiologic assessment of aneurysm wall allowing to approach to the level of histological accuracy.
About the authors
M. V. Vishnyakova Jr.
Moscow Regional Research and Clinical Institute (MONIKI)
Author for correspondence.
Email: cherridra@mail.ru
PhD, Senior Research Fellow, Department of Roentgenology
РоссияR. N. Lar’kov
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
PhD, Head of Department of Vascular and IHD Surgery
РоссияM. V. Vishnyakova
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
MD, PhD, Head of Department of Roentgenology
РоссияA. G. Osiev
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
MD, PhD, Professor, Head of Department of Cardiovascular Surgery
РоссияReferences
- Казанчян ПО, Попов ВА. Осложнения в хирургии аневризм брюшной аорты. М.: МЭИ; 2002. 304 с. Kazanchyan PO, Popov VA. Oslozhneniya v khirurgii anevrizm bryushnoy aorty [Complications of abdominal aortic aneurysm surgery]. Moscow: MEI; 2002. 304 p. (in Russian).
- Endovascular stent-grafts for the treatment of abdominal aortic aneurysms. February 2009. NICE technology appraisal guidance 167. Available from: https://www.nice.org.uk/guidance/ta167
- 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation. 2010;121(13):e266–369.
- Fleming C, Whitlock EP, Beil TL, Lederle FA. Screening for abdominal aortic aneurysm: a best-evidence systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2005;142(3):203–11.
- Chaikof EL, Brewster DC, Dalman RL, Makaroun MS, Illig KA, Sicard GA, Timaran CH, Upchurch GR Jr, Veith FJ; Society for Vascular Surgery. The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. J Vasc Surg. 2009;50(4 Suppl):S2–49.
- Покровский АВ, Вафина ГР. Пенетрирующие атеросклеротические язвы аорты. Ангиология и сосудистая хирургия. 2012;18(4):8–14. Pokrovskiy AV, Vafina GR. Penetriruyushchie ateroskleroticheskie yazvy aorty [Penetrating aortic ulcers]. Angiologiya i sosudistaya khirurgiya [Angiology and Vascular Surgery]. 2012;18(4):8–14 (in Russian).
- Сорокин ВА, Щава СП. Острая патология грудного отдела аорты в практике терапевта. Дальневосточный медицинский журнал. 2010;(1):127–30. Sorokin VA, Shchava SP. Ostraya patologiya grudnogo otdela aorty v praktike terapevta. Dal'nevostochnyy meditsinskiy zhurnal [Acute pathology of thoracic aorta in practice of an internist]. Dal'nevostochnyy meditsinskiy zhurnal [Far Eastern Medical Journal]. 2010;(1): 127–30 (in Russian).
- Macura KJ, Corl FM, Fishman EK, Bluemke DA. Pathogenesis in acute aortic syndromes: aortic dissection, intramural hematoma, and penetrating atherosclerotic aortic ulcer. AJR Am J Roentgenol. 2003;181(2):309–16. Macura KJ, Corl FM, Fishman EK, Bluemke DA. Pathogenesis in acute aortic syndromes: aortic dissection, intramural hematoma, and penetrating atherosclerotic aortic ulcer. AJR Am J Roentgenol. 2003;181(2):309–16.
- Vilacosta I, Roman JA. Acute aortic syndrome. Heart. 2001;85(4):365–8.
- Вишнякова МВ. Роль мультиспиральной компьютерной томографии в диагностике аневризм аорты, имеющих осложнен-
- ное течение. Медицинская визуализация. 2013;(3):35–40. Vishnyakova MV. Rol' mul'tispiral'noy komp'yuternoy tomografii v diagnostike anevrizm aorty, imeyushchikh oslozhnennoe techenie [Multidetector computed tomography in diagnosis of complicated course of aortic aneurysm]. Meditsinskaya vizualizatsiya [Medical Imaging]. 2013;(3):35–40 (in Russian).
- Вишнякова МВ (мл.). Роль мультиспиральной компьютерной томографии в диагностике интрамуральной гематомы при аневризме аорты. Медицинская визуализация. 2012;(3):70–6.
- Litmanovich D, Bankier AA, Cantin L, Raptopoulos V, Boiselle PM. CT and MRI in diseases of the aorta. AJR Am J Roentgenol.
- ;193(4):928–40.
- Schwartz SA, Taljanovic MS, Smyth S, O'Brien MJ, Rogers LF. CT findings of rupture, impending rupture, and contained rupture of abdominal aortic aneurysms. AJR Am J Roentgenol. 2007;188(1):W57–62.
- Walker DI, Bloor K, Williams G, Gillie I. Inflammatory aneurysms of the abdominal aorta. Br J Surg. 1972;59(8):609–14.
- Rasmussen TE, Hallett JW Jr. Inflammatory aortic aneurysms. A clinical review with new perspectives in pathogenesis. Ann Surg.1997;225(2):155–64.
- Прокоп М, Галански М. Спиральная и многослойная компьютерная томография. Пер. с англ. М.: Медэкспресс-информ; 2007. Т. 2. 710 с. Prokop M, Galanski M, editors. Spiral'naya i mnogosloynaya komp'yuternaya tomografiya. Transl. from Engl. [Spiral and multislice computed tomography of the body]. Moscow: Medekspress-inform; 2007. Vol. 2. 710 p. (in Russian).
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