Aortography
Encyclopedia
An aortogram involves placement of a catheter
in the aorta
and injection of contrast material while taking x-rays of the aorta. The procedure is known as aortography. The diagnosis of aortic dissection can be made by visualization of the intimal flap and flow of contrast material in both the true lumen and the false lumen.
The aortogram was previously considered the gold standard test
for the diagnosis of aortic dissection, with a sensitivity of up to 88% and a specificity of about 94%. It is especially poor in the diagnosis of cases where the dissection is due to hemorrhage within the media without any initiating intimal tear.
The advantage of the aortogram in the diagnosis of aortic dissection is that it can delineate the extent of involvement of the aorta and branch vessels and can diagnose aortic insufficiency
.
The disadvantages of the aortogram are that it is an invasive procedure and it requires the use of iodinated contrast material.
In modern medicine, it has been replaced by the diagnostic tools of MRI, CT, and transesophageal echocardiography(TEE) all of which have sensitivities that exceed 90%. TEE is favored in emergent situations, as it is relatively non-invasive and a rapid procedure (more so than MRI, which can takes hours). (references needed)
Catheter
In medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters thereby allow drainage, administration of fluids or gases, or access by surgical instruments. The process of inserting a catheter is catheterization...
in the aorta
Aorta
The aorta is the largest artery in the body, originating from the left ventricle of the heart and extending down to the abdomen, where it branches off into two smaller arteries...
and injection of contrast material while taking x-rays of the aorta. The procedure is known as aortography. The diagnosis of aortic dissection can be made by visualization of the intimal flap and flow of contrast material in both the true lumen and the false lumen.
The aortogram was previously considered the gold standard test
Gold standard (test)
In medicine and statistics, gold standard test refers to a diagnostic test or benchmark that is the best available under reasonable conditions. It does not have to be necessarily the best possible test for the condition in absolute terms...
for the diagnosis of aortic dissection, with a sensitivity of up to 88% and a specificity of about 94%. It is especially poor in the diagnosis of cases where the dissection is due to hemorrhage within the media without any initiating intimal tear.
The advantage of the aortogram in the diagnosis of aortic dissection is that it can delineate the extent of involvement of the aorta and branch vessels and can diagnose aortic insufficiency
Aortic insufficiency
Aortic insufficiency , also known as aortic regurgitation , is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle....
.
The disadvantages of the aortogram are that it is an invasive procedure and it requires the use of iodinated contrast material.
In modern medicine, it has been replaced by the diagnostic tools of MRI, CT, and transesophageal echocardiography(TEE) all of which have sensitivities that exceed 90%. TEE is favored in emergent situations, as it is relatively non-invasive and a rapid procedure (more so than MRI, which can takes hours). (references needed)