Evaluation of Aortic Disease with Spiral CT Angiography and Multiplanar Reconstructions: Comparison with Catheter Angiography

Purpose: To assess the usefulness of spiral CT angiography (CTA) in the evaluation of aortic aneurysm (AA) or dissection (AD). Methods: Ninety-eight patients with AA (n = 78) or AD (n = 20) were examined with CTA. Imaging results were correlated with angiographic (n = 98) findings in all cases and surgical findings in AA cases (n = 64). The spiral CT angiography were analyzed by an experienced radiologist without knowledge of the result of the catheter angiography, to evaluate the same features. The catheter angiograms were individually interpreted by two experienced radiologists. Results: In AA, all of major aortic branches were depicted on CTA except two of seven accessory renal arteries and six of 26 inferior mesenteric arteries. CTA correctly assessed aneurysm involvement of left subclavian (LSA), renal (RA), and iliac arteries (IA) in all patients. In AD, CTA correctly assessed Stanford classification in all patients, and the relationship between 70 major aortic branches and true/false lumen in all but two branches. CTA showed 23 of 30 intimal tears in double barreled AD. Conclusion: CTA might replace catheter angiography in evaluation of AA and AD except in cases of type A dissection. Index Terms: computed tomography - CT angiography - aorta, aneurysm - aorta, dissection - Catheter angiograph