Ulus Travma Acil Cerrahi Derg. 2007; 13(2): 106-114

Akut aortik diseksiyonun tanýsýnda manyetik rezonans görüntüleme

Ahmet Mesrur Halefoðlu
Þiþli Etfal Eðitim Ve Araþtýrma Hastanesi Radyoloji Kliniði, Ýstanbul, Türkiye

AMAÇ: Çalýþmamýzda akut aortik disseksiyonun acil tanýsýnda manyetik rezonans ( MR ) görüntülemenin yararlýlýðýný ortaya koymaya çalýþtýk. GEREÇ-YÖNTEM: Bu çalýþmada klinik olarak aortik disseksiyon þüphesi olan 15 hastanýn 1.5 tesla MR cihazý ile hem MR görüntüleri ve hem de 3 boyutlu kontrastlý MR anjiografi görüntüleri elde edildi.
BULGULAR: MR görüntüleme ile 11 hastaya aortik disseksiyon tanýsý konuldu. Tüm olgularda hem intimal flebin gösterilmesi ve hem de disseksiyonun A veya B tipinde olduðunun belirlenmesi mümkün oldu. Tüm olgulara anjiografi yapýldý ve 3 hasta opere edildi. MR sonuçlarý gold standart olarak kabul edilen anjiografi ve operasyon sonuçlarý ile kýyaslandý. SONUÇ: Sonuç olarak, MR görüntülemenin aortik disseksiyonlu hastalarda hem baþlangýçta taný amaçlý olarak ve hem de bu hastalarýn uzun dönemli takiplerinde kullanýlabilecek bir modalite olduðunu söyleyebiliriz.

Anahtar Kelimeler: Akut aortik sendrom, Aortik disseksiyon, Taný, Manyetik rezonans görüntüleme, Prognoz, Tedavi.

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Emergency diagnosis of acute aortic dissection using magnetic resonance imaging

Ahmet Mesrur Halefoðlu
Sisli Etfal Training And Research Hospital, Istanbul, Turkey

BACKGROUND: In our study, we aimed to demonstrate the utility of MR imaging in the emergency diagnosis of acute aortic dissection. METHODS: Herein, 15 patients who were clinically suspected as having aortic dissection were assessed with both magnetic resonance imaging and 3D contrast enhanced MR angiography by means of a 1.5 tesla magnet. RESULTS: Eleven patients were diagnosed as having aortic dissection by means of MRI. We were able to show the intimal flap in all of the aortic dissection patients and we also determined whether the dissection type was A or B. Although the dissections in three patients were found to be in proximal location (type A), eight patients showed a distally located (type B) dissection. All patients were subjected to angiography and 3 patients were operated. Our results were compared with the results of the angiography and operation, which were regarded as the gold standards. CONCLUSION: Consequently, we can state that MR imaging may be used as an initial diagnostic modality for the patients with aortic dissection and this method can also serve as an useful method in the long term follow-up of these patients. It is a non-invasive and sensitive modality that is easy to perform and can be applied instead of other diagnostic modalities such as conventional angiography.

Keywords: Acute aortic syndrome, Aortic dissection, Diagnosis, Magnetic resonance imaging, Prognosis, Treatment.

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