Diagnostics

Indications: may be conducted as an initial imaging study in patients with chest pain and/or dyspnea

Suggestive findings [8][9][11]

• Abnormal aortic contour

• Widened mediastinum

• Tracheal deviation

Indications: best confirmatory test for TAAs

• Abnormal findings on chest x-ray, ultrasound, or echocardiography

• Interventional planning and follow-up

• Detailed evaluation of the extent, length, angulation, and diameter of the aneurysm

• Evaluation of aortic branch involvement

Supportive findings [9][10]

• Dilatation of the aorta [8]

• Possible mural thrombus (nonenhancing)

• Possible dissection, perforation, or rupture

MR angiography chest with and without IV contrast

• Indication: Consider as an alternative to CTA. [10]

  • In stable patients who should avoid ionizing radiation

  • For serial follow-ups

• Supportive findings: similar to CTA

Transthoracic echocardiography [10]

• Indications

  • Rapid assessment in hemodynamically unstable patients

  • Evaluation for concomitant heart disease

• Supportive findings

  • Dilatation of the aorta

  • Possible cardiac pathology

  • Signs of coronary artery disease [12]

Transesophageal echocardiography: allows for more accurate assessment than TTE [10]

• Indication: intraoperative monitoring

Catheter angiography (aortography) [11]

• Indications

  • Evaluation and possibly treatment of coexisting coronary artery disease

  • Assessment of aortic lumen and branch vessels

• Supportive findings: contrast column in the lumen of the aneurysm