Pseudo-dissection of aorta: wall-motion artifact mimicking aortic dissection with a patent false lumen
Yoshitaka Yamane, Naomichi Uchida, Shingo Mochizuki, Tomokuni Furukawa, Kazunori Yamada
2016
European Heart Journal-Cardiovascular Imaging
A et al. Reproducibility of coronary optical coherence tomography for lumen and length measurements in humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] study. Am J Cardiol 2012;110:1106 -12. 12. Huisman J, Egede R, Rdzanek A, Bö se D, Erbel R, Kochman J et al. Between-centre reproducibility of volumetric intravascular ultrasound radiofrequency-based analyses in mild-to-moderate coronary atherosclerosis: an international multicentre study. EuroIntervention 2010;5:925 -31.
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... . Regar E, Werner F, Siebert U, Rieber J, Thesen K, Mudra H et al. Reproducibility of neointima quantification with motorized intravascular ultrasound pullback in stented coronary arteries. Am Heart J 2000;139:632 -7. 14. Vakoc B, Yun S, de Boer J, Tearney GJ, Bouma BE. Phase-resolved optical frequency domain imaging. Opt Express 2005;13:5483 -93. 15. Jamil Z, Tearney G, Bruining G, Sihan K, van Soest G, Lightart J et al. Interstudy reproducibility of the second generation, Fourier domain optical coherence tomography in patients with coronary artery disease and comparison with intravascular ultrasound: a study applying automated contour détection. Int J Cardiovasc Imaging 2013;29:39-51. 16. Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis. Nat Methods 2012;9:671 -5. 17. Landis JR, Koch GG. The measurement of observer agreement for categorical data. A 40-year-old obese man with a history of hypertension and sleep apnea was admitted to another hospital because of sudden chest pain. Computed tomography (CT) revealed type A acute aortic dissection (AAD), and he was referred to our hospital for surgery. The CT images from the referring hospital showed aortic dissection with a patent false lumen from the aortic root to the ascending aorta (Panels A-C, arrow). The entry site and pericardial effusion were not seen. UCG did not reveal dissection of the ascending aorta due to poor echocardiographic images. We initially suspected it was AAD from the physical findings and CT scan, and that he would require emergent surgery. However, there was the possibility of a wall-motion artifact, and thus we performed ECG-gated CT. This showed no aortic pathology (Panel D). Enhanced CT has high sensitivity and specificity for all aortic dissections. However, with ascending dissections, there is the potential for false-positive results. When it is difficult to diagnose AAD, ECG-gated CT is useful, and it may prevent unnecessary surgery. Published on behalf of the
doi:10.1093/ehjci/jew065
pmid:27056476
fatcat:d23mnzy3pjbsfotpxxe66bhim4