RESUMO
Computed tomographic angiography (CTA) has gained wide clinical acceptance as a powerful diagnostic tool in the non-invasive evaluation of vascular disorders and has became the method of choice for the assessment of aortic pathology. In addition, recent advances in computed tomography (CT) technology improve the image quality and diagnostic performance of the procedure in the abdominal vascular system. In this paper, we briefly review the CTA technique and describe the main applications of abdominal CTA.
Assuntos
Angiografia/métodos , Angioscopia/métodos , Radiografia Abdominal/métodos , Tomografia Computadorizada por Raios X/métodos , Doenças Vasculares/diagnóstico por imagem , Meios de Contraste , Humanos , Imageamento Tridimensional , Iohexol/análogos & derivados , Interface Usuário-ComputadorRESUMO
Type A aortic dissection is usually treated with standard surgery, requiring cardiopulmonary bypass and sometimes deep hypothermia. Besides the well-established procedure, mortality and complications are considerable. Using the knowledge and lessons learned from the endovascular treatment of descending aortic diseases, emerging reports describe new approaches to the condition, using endovascular stent-grafts. This report describes an endovascular treatment of a chronic type A aortic dissection without cardiopulmonary bypass and avoiding thoracotomy.
Assuntos
Angioscopia/métodos , Aneurisma da Aorta Torácica/cirurgia , Dissecção Aórtica/cirurgia , Implante de Prótese Vascular/métodos , Dissecção Aórtica/diagnóstico por imagem , Angiografia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Doença Crônica , Humanos , Masculino , Pessoa de Meia-Idade , StentsRESUMO
BACKGROUND: Computed tomographic (CT) angiography represents an important clinical tool in the evaluation of vascular disorders. Virtual angioscopy can be reconstructed with volumetric CT data sets. We evaluated the feasibility and clinical value of this application in the assessment of abdominal vessels. METHODS: Data sets of CT angiographic studies obtained with helical (n = 120) and multislice (n = 180) CT scanners were analyzed on a workstation for postprocessing. Vascular evaluation was done on conventional enhanced axial images, three-dimensional reconstructions, and virtual angioscopic images. RESULTS: We made 123 studies in patients without aortic disease. Of the patients evaluated for stent-graft treatment, 63 showed normal patency, seven had partial thrombosis of the stent-graft, five showed total occlusion of the stent-graft, and 10 had leaks. From the 92 remaining CT studies, 63 vascular aneurysms and nine dissections were diagnosed. CONCLUSION: The current technology produces high-quality virtual angioscopic images. Although axial and multiplanar views are usually adequate for detecting a vascular disorder, virtual angioscopic views better define anatomic details.