Computed Tomography Criteria for Differential Evaluation of True and False Lumens in Aortic Dissection
https://doi.org/10.23934/2223-9022-2022-11-3-394-401
Abstract
The aim of study Based on computed tomography data, to determine the most characteristic criteria for true lumen (TL) and false lumen (FL) in aortic dissection. To identify the relationship of the studied features with the stage of aortic dissection.
Materials of the study Computed tomography (CT) data of 115 patients diagnosed with aortic dissection (AD) who were treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine were analyzed. The average age of the patients was 54.5 years (median — 56 years), men predominated in the studied group. AD types according to the De Bakey classification were distributed as follows: Type I — in 47% of patients, Type II — in 16.5%, Type III — in 36.5%. Dissection in the acute stage occurred in 62% of the patient, in the subacute — in 16%, in the chronic — 22%.
Results In the studied group, FL in all cases prevailed over the TL by size, regardless of the stage and type of AD. Analysis of lumen ratio showed that in 63.55% of patients, FL occupied 75% or more of the aortic cross-sectional area. Location of FL: at the level of the ascending aorta, along the right and anterior walls of the aorta — 94.5%; in the descending thoracic aorta, along the posterior and left walls — 84%; in the abdominal aorta, along the posterior and left walls — 70%. Calcifications of the non- dissected part of the aortic wall, as a sign of a true lumen, were found in 59.1%. There was no correlation between calcification and the AD stage. Partial thrombosis of one of the lumens was detected in 59% (in FL — 85%, in TL — 13%, thrombosis of both lumens — 2%). The beak signs occurred in 85% of patients with AD, however, it was significantly more often detected in patients with acute and subacute AD stages than in the chronic stage (p<0.001). The cobweb sign was found in one third of patients with AD, however, it was statistically significantly more often determined in patients in acute and subacute stages (p<0.05).
Conclusion CT is reasonably considered a highly informative method of diagnosing AD. The signs of true and false lumen presented in the work, as well as their combination, make it possible to perform a quick and error-free marking of the aortic lumen with a high degree of probability. A number of the described CT signs correlate with the stage of AD.
About the Authors
R. S. MuslimovRussian Federation
Rustam Sh. Muslimov Candidate of Medical Sciences, Leading Researcher, Department of Diagnostic Radiology
129090, Moscow, Bolshaya Sukharevskaya Sq., 3
I. E. Popova
Russian Federation
Irina E. Popova Candidate of Medical Sciences, Senior Researcher, Department of Diagnostic Radiology
129090, Moscow, Bolshaya Sukharevskaya Sq., 3
L. T. Khamidova
Russian Federation
Layla T. Khamidova Doctor of Medical Sciences, Head, Department of Diagnostic Radiology
129090, Moscow, Bolshaya Sukharevskaya Sq., 3
V. S. Selyaev
Russian Federation
Vladislav S. Selyaev Junior Researcher, Department of Emergency Cardiac Surgery, Assisted Circulation and Heart Transplantation
129090, Moscow, Bolshaya Sukharevskaya Sq., 3
I. V. Vasilyeva
Russian Federation
Irina V. Vasilyeva Candidate of Medical Sciences, Associate Professor, Department of Medical Statistics and Informatics, Medico-Biologocal Faculty
117997, Moscow, Ostrovityanova str., 1
L. S. Kokov
Russian Federation
Leonid S. Kokov Academician (Full Member) of the Russian Academy of Sciences, Full Professor, Head, Scientific Department of Emergency Cardiology and Cardiovascular Surgery
129090, Moscow, Bolshaya Sukharevskaya Sq., 3
127473, Moscow, Delegatskaya str., 20, bld. 1
119991, Moscow, Trubetskaya str., 8, bld. 2
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Review
For citations:
Muslimov R.S., Popova I.E., Khamidova L.T., Selyaev V.S., Vasilyeva I.V., Kokov L.S. Computed Tomography Criteria for Differential Evaluation of True and False Lumens in Aortic Dissection. Russian Sklifosovsky Journal "Emergency Medical Care". 2022;11(3):394-401. https://doi.org/10.23934/2223-9022-2022-11-3-394-401