One stop shop angiography using dual source CT: Comprehensive evaluation of Stanford type A aortic dissection

Objective: To investigate the feasibility of comprehensive assessment for Stanford type A aortic dissection (AD) including survey of aortic root structure, coronary artery and function of left ventricular using dual source computed tomography angiography (DSCTA). Methods: Thirty-six patients with Stanford type A AD underwent retrospective ECG-gating CT angiography using DSCT. The imaging quality and abnormalities of coronary artery, aorta and aortic valve were evaluated. The diameter of aortic root, function of left ventricular and radiation dose were evaluated and compared with surgical results. Results: Thirty-five patients completed the examination. Acceptable image quality was achieved in 97.14% (34/35) for aorta and aortic valve, 93.10% (445/478) coronary arterial segments. Right valsalva sinus was involved in 17, non-coronary valsalva sinus in 15, left valsalva sinus in 5, the joint area of right-non sinus in 13, left-right sinus in 3 and left-none sinus in 1 patient. The average diameter of valsalva sinuses, aortic annulus, and proximal aorta was (41.6±9.4)mm, (28.2±4.1)mm and (73.6±10.2)mm, respectively. The left ventricular ejection fraction negatively related to the degree of arotic valve insufficiency (r=-0.97, P=0.02). The average effective radiation dose was (21.96±4.36)mSv. The diagnosis agreement between classification diagnosis of MSCTA and pathology was 88.24% (30/34), and the consistency was excellent (Kappa=0.82, P<0.01). Conclusion: One stop shop MSCTA can provide comprehensive assessment for Stanford type A AD, including survey of aortic root structure, coronary artery and function of left ventricular.