This Article Full Text Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Leiner, T. Articles by van Engelshoven, J. M. A. Search for Related Content PubMed PubMed Citation Articles by Leiner, T. Articles by van Engelshoven, J. M. A. Related Collections Cardiovascular imaging agents/Techniques CT and MRI CV surgery: aortic and vascular disease

(Circulation. 2001;103:e76.)
© 2001 American Heart Association, Inc.

Images in Cardiovascular Medicine

Magnetic Resonance Angiography of an Aortic Dissection

Tim Leiner, MD; Ted W. O. Elenbaas, MD; Dave W. Kaandorp, PhD; Kai Yiu J. A. M. Ho, MD, PhD; Michiel W. de Haan, MD; Jos M. A. van Engelshoven, MD, PhD

From the Departments of Radiology (T.L., D.W.K., K.Y.J.A.M.H., M.W.d.H., J.M.A.v.E.) and Cardiothoracic Surgery (T.W.O.E.), Maastricht University Hospital, Maastricht, Netherlands.

A 51-year-old man with hypertension had previously been admitted to our cardiothoracic unit with a type A aortic dissection (Stanford classification) and had undergone emergency surgery with partial replacement of the ascending aorta. Routine follow-up magnetic resonance angiography (MRA) 19 months after the operation revealed an aneurysm at the incision site in the ascending aorta and extension of the dissection into the descending aorta. MRA was performed with 2 sequential breath-hold 3D contrast-enhanced scans, each lasting 25 seconds.^{1 2} The resolution of the reconstructed images was 2.0x2.2x1.5 mm. For postprocessing, the scans were sent to an offline workstation (EasyVision, Philips Medical Systems), where 3D shaded surface renderings were created. Surface renderings of the first scan allowed excellent evaluation of the ascending and descending aorta as well as the aortic arch. In the ascending aorta, a patch-like aneurysm 7x19x29 mm was seen (Figures 1 and 2). The descending aorta shows tapering of the lumen from just proximal to the diaphragmatic hiatus all the way into the iliac arteries. Images of the second scan clearly show the filling of a huge false lumen from the iliac arteries all the way up to the diaphragmatic hiatus (Figures 3 and 4). The total length of the dissection is >25 cm. On image 4, it can be appreciated that the left kidney is dependent on the false lumen for its blood supply. Examination of the source images showed that the only patent connection between the true . . . [Full Text of this Article]