Abstract
The acute aortic syndrome can be caused by three interrelated conditions involving the aorta with possibility of rupture – aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer. Diagnostic imaging plays a pivotal role in diagnosis and management, with CT being the most commonly utilized. Although there is significant overlap between these three entities, understanding both the pathophysiology and imaging features is essential for facilitating prompt diagnosis and management.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Vilacosta I. Acute aortic syndrome. Heart. 2001;85(4):365–8.
Maddu KK, Shuaib W, Telleria J, Johnson J-O, Khosa F. Nontraumatic acute aortic emergencies: Part 1, Acute aortic syndrome. Am J Roentgenol [Internet]. 2014; Available from: https://www.ajronline.org/doi/full/10.2214/AJR.13.11437
Manriquez M, Srinivas G, Bollepalli S, Britt L, Drachman D. Is computed tomography a reliable diagnostic modality in detecting placental injuries in the setting of acute trauma? Am J Obstet Gynecol. 2010;202(6):611.e1–5.
The International Registry of Acute Aortic Dissection (IRAD): New insights into an old disease | Surgery | JAMA | JAMA Network [Internet]. 2020. Available from: https://jamanetwork.com/journals/jama/fullarticle/192401
Yoo SM, Lee HY, White CS. MDCT evaluation of acute aortic syndrome. Radiol Clin N Am. 2010;48(1):67–83.
Chiu KWH, Lakshminarayan R, Ettles DF. Acute aortic syndrome: CT findings. Clin Radiol. 2013;68(7):741–8.
Valente T, Rossi G, Lassandro F, Rea G, Marino M, Muto M, et al. MDCT evaluation of acute aortic syndrome (AAS). Br J Radiol. 2016;89(1061):20150825.
Ramanath VS, Oh JK, Sundt TM, Eagle KA. Acute aortic syndromes and thoracic aortic aneurysm. Mayo Clin Proc. 2009;84(5):465–81.
Khan IA, Nair CK. Clinical, diagnostic, and management perspectives of aortic dissection. Chest. 2002;122(1):311–28.
Hartnell GG. Imaging of aortic aneurysms and dissection: CT and MRI. J Thorac Imaging. 2001 Jan;16(1):35–46.
Castañer E, Andreu M, Gallardo X, Mata JM, Cabezuelo MÁ, Pallardó Y. CT in nontraumatic acute thoracic aortic disease: typical and atypical features and complications. RadioGraphics. 2003;23(suppl_1):S93–S110.
Bennett CJ, Maleszewski JJ, Araoz PA. CT and MR imaging of the aortic valve: radiologic-pathologic correlation. RadioGraphics. 2012;32(5):1399–420.
Larson EW, Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol. 1984;53(6):849–55.
Rubin GD, Helical CT. Angiography of the thoracic aorta. J Thorac Imaging. 1997;12(2):128–49.
Nienaber CA, Eagle KA. Aortic dissection: new frontiers in diagnosis and management: Part I: From etiology to diagnostic strategies. Circulation. 2003;108(5):628–35.
Nelsen KM, Spizarny DL, Kastan DJ. Intimointimal intussusception in aortic dissection: CT diagnosis. AJR Am J Roentgenol. 1994;162(4):813–4.
Karabulut N, Goodman LR, Olinger GN. CT diagnosis of an unusual aortic dissection with intimointimal intussusception: the wind sock sign. J Comput Assist Tomogr. 1998;22(5):692–3.
Tam DY, Mazine A, Cheema AN, Yanagawa B. Conservative management of extensive iatrogenic aortic dissection. Aorta J. 2016;4(6):229–31.
Leontyev S, Borger MA, Legare J-F, Merk D, Hahn J, Seeburger J, et al. Iatrogenic type A aortic dissection during cardiac procedures: early and late outcome in 48 patients. Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg. 2012;41(3):641–6.
Rylski B, Hoffmann I, Beyersdorf F, Suedkamp M, Siepe M, Nitsch B, et al. Iatrogenic acute aortic dissection type A: insight from the German Registry for Acute Aortic Dissection Type A (GERAADA). Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg. 2013;44(2):353–9. discussion 359
Acute retrograde type A aortic dissection: morphologic analysis and clinical implications | Elsevier Enhanced Reader [Internet]. 2020. Available from: https://reader.elsevier.com/reader/sd/pii/S0022480417300811?token=D887031BB90F8C302E1A295CCE2BB1AD6CB781C6F0F46AA290D1847F4EB124D423364DBCD136456BF94F91577B9C9576
Kamohara K, Furukawa K, Koga S, Yunoki J, Morokuma H, Noguchi R, et al. Surgical strategy for retrograde type A aortic dissection based on long-term outcomes. Ann Thorac Surg. 2015;99(5):1610–5.
Restrepo CS, Lemos DF, Lemos JA, Velasquez E, Diethelm L, Ovella TA, et al. Imaging findings in cardiac tamponade with emphasis on CT. RadioGraphics. 2007;27(6):1595–610.
Gutschow SE, Walker CM, Martínez-Jiménez S, Rosado-de-Christenson ML, Stowell J, Kunin JR. Emerging concepts in intramural hematoma imaging. RadioGraphics. 2016;36(3):660–74.
Evangelista A, Mukherjee D, Mehta RH, O’Gara PT, Fattori R, Cooper JV, et al. Acute intramural hematoma of the aorta: a mystery in evolution. Circulation. 2005;111(8):1063–70.
Song J-K, Yim JH, Ahn J-M, Kim D-H, Kang J-W, Lee TY, et al. Outcomes of patients with acute type A aortic intramural hematoma. Circulation. 2009;120(21):2046–52.
Hayashi H, Matsuoka Y, Sakamoto I, Sueyoshi E, Okimoto T, Hayashi K, et al. Penetrating atherosclerotic ulcer of the aorta: imaging features and disease concept. RadioGraphics. 2000;20(4):995–1005.
Saremi F, Hassani C, Lin LM, Lee C, Wilcox AG, Fleischman F, et al. Image predictors of treatment outcome after thoracic aortic dissection repair. RadioGraphics. 2018;38(7):1949–72.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this entry
Cite this entry
Steinbrecher, K.L., Bhalla, S., Marquis, K.M., Raptis, C.A. (2022). Acute Aortic Syndrome Imaging. In: Patlas, M.N., Katz, D.S., Scaglione, M. (eds) Atlas of Emergency Imaging from Head-to-Toe. Springer, Cham. https://doi.org/10.1007/978-3-030-92111-8_17
Download citation
DOI: https://doi.org/10.1007/978-3-030-92111-8_17
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-92110-1
Online ISBN: 978-3-030-92111-8
eBook Packages: MedicineReference Module Medicine