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      Combined CT angiography of the aorta and craniocervical artery: a new imaging protocol for assessment of acute type A aortic dissection

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          Abstract

          Background

          To investigate the feasibility of combined computed tomography angiography (CTA) of the aorta and craniocervical artery in acute type A aortic dissection (ATAAD) and the value of incremental craniocervical information.

          Methods

          Combined CTA of head, neck and aorta was performed in patients with suspected aortic dissection and 243 ATAAD patients were analyzed. The image quality and radiation dose were assessed. Valuable craniocervical CTA findings were determined for further surgical analysis.

          Results

          The mean dose-length product (DLP) was 314.11±29.31 mGy.cm. The image quality of craniocervical arteries were 100% diagnostic. Intimal flap involving carotid arteries was detected in 47% of patients, and significant stenosis of true lumen was observed in 60% of common carotid arteries (CCAs). Hypodensity and hypoplasia/occlusion of carotid arteries were also detected and apprised surgeons. The tortuosity of carotid artery was found in 90.9% of patients. Bilateral antegrade selective cerebral perfusion (ASCP) was performed in 21.1% of aortic arch surgery based on 7 hemodynamic variation types of the circle of Willis (CW) determined by cranial CTA information.

          Conclusions

          A combined CTA of head, neck and aorta is feasible with low radiation dose and diagnostic image quality. Incremental information on craniocervical pathology and anatomy may be useful for surgery repair of ATAAD.

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          Author and article information

          Journal
          J Thorac Dis
          J Thorac Dis
          JTD
          Journal of Thoracic Disease
          AME Publishing Company
          2072-1439
          2077-6624
          November 2017
          November 2017
          : 9
          : 11
          : 4733-4742
          Affiliations
          [1 ]Department of Radiology, Xijing Hospital, Fourth Military Medical University , Xi’an 710032, China
          [2 ]Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University , Xi’an 710032, China
          Author notes

          Contributions: (I) Conception and design: M Zheng; (II) Administrative support: D Wen, R An; (III) Provision of study materials or patients: W Duan; (IV) Collection and assembly of data: H Zhao, J Li; (V) Data analysis and interpretation: H Zhao, J Li; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

          Correspondence to: Minwen Zheng, MD. Department of Radiology, Xijing Hospital, Fourth Military Medical University, 127# West Changle Road, Xi’an 710032, China. Email: zhengmw2007@ 123456163.com .
          Article
          PMC5720980 PMC5720980 5720980 jtd-09-11-4733
          10.21037/jtd.2017.09.28
          5720980
          29268544
          e3857029-3427-44f0-89b3-3b9beed7abaa
          2017 Journal of Thoracic Disease. All rights reserved.
          History
          : 20 June 2017
          : 01 September 2017
          Categories
          Original Article on Quantitative Imaging of Thoracic Diseases

          aortic surgery,Computed tomography angiography (CTA),aortic dissection,circle of Willis (CW),cerebral protection

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