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MDCT in diagnosing acute aortic syndromes: reviewing common and less common CT findings

Utilizzo della TC multidetettore nella diagnosi delle sindromi aortiche a cute: revisione dei segni TC più e meno comuni

  • Vascular and Interventional Radiology / Radiologia Vascolare e Interventistica
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Nontraumatic acute thoracic aortic syndromes (AAS) describe a spectrum of life-threatening aortic pathologies with significant implications on diagnosis, therapy and management. In this context, multidetector computed tomography (MDCT) is the gold standard due to its intrinsic diagnostic value; its performance approaches 100% sensitivity and specificity, and it is accepted as a first-line modality for suspected acute aortic disease. MDCT allows early recognition and characterisation of acute aortic syndromes as well as the presence of any associated complications — findings that are essential for optimising treatment and improving clinical outcomes. Although classic CT findings have long been known, other unusual signs are continually reported in the medical literature. We reviewed the classic and less common CT findings, correlating them with pathophysiology, timing and management options, to achieve a definite and timely diagnostic and therapeutic definition.

Riassunto

Di recente sistematizzazione, le sindromi aortiche acute rappresentano uno spettro di condizioni patologiche assai temibili per le notevoli implicazioni diagnostiche, terapeutiche e gestionali. In questo contesto, la tomografia computerizzata multidetettore (TCMD) è attualmente il gold standard per il suo intrinseco valore diagnostico, con sensibilità e specificità vicine al 100%, e costituisce la tecnica di imaging di scelta per sospetta patologia aortica acuta. La TCMD consente il riconoscimento precoce e la caratterizzazione delle sindromi aortiche acute, nonché la presenza di eventuali complicanze associate, con risultati essenziali per ottimizzare il trattamento e migliorare la prognosi. La semeiotica TC classica è nota da tempo, costituita da alcuni segni frequenti ed altri certamente più insoliti. Lo scopo di questo lavoro è rivedere la semeiotica classica e soprattutto evidenziare gli aspetti TC meno frequenti, correlandoli alla fisiopatologia, al timing e alle opzioni gestionali al fine di raggiungere una più precisa e tempestiva definizione diagnostica e terapeutica.

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Authors and Affiliations

  1. Dipartimento d Diagnostica per Immagini, Servizio di Radiologia, A.O.R.N. V. Monaldi, Napoli, Italy

    T. Valente, G. Rossi, F. Lassandro, M. Marino, G. Tortora & R. Muto

  2. Dipartimento di Diagnostica per Immagini, Presidio Ospedaliero “Pineta Grande”, Via Domiziana Km. 30, 81030, Castel Volturno, Italy

    M. Scaglione

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  1. T. Valente
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  2. G. Rossi
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  3. F. Lassandro
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  7. M. Scaglione
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Correspondence to M. Scaglione.

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Valente, T., Rossi, G., Lassandro, F. et al. MDCT in diagnosing acute aortic syndromes: reviewing common and less common CT findings. Radiol med 117, 393–409 (2012). https://doi.org/10.1007/s11547-011-0747-9

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