Diagnosis of aortic dissection by digital subtraction angiography

The aim of the study was to determine whether digital subtraction angiography (DSA) can be used in the diagnosis of aortic dissection. The study group consisted of six patients with aortic dissection including one of type 2 and five of type 3 by the DeBakey classification. DSA findings were compared to cineangiographic findings. The results were as follows; 1) In all the patients, the diagnosis of aortic dissection was possible using DSA. Especially as to the entry, which was not detected by other non-invasive methods, there was an excellent correlation between cineangiograms and DSA (sensitivity 100%). 2) Of the 20 vessels in the abdomen, which included the celiac, superior mesentric, and right and left renal arteries, three vessels (15%) were not identified by DSA. Causes of the failure were the low spatial resolution and the artifact due to the motion of the patients and intestinal gas movement. The accuracy rate of the abdominal branch involvement was 70%. 3) While using a prototype equipment, the preliminary study showed that DSA is a safe and very useful method not only for diagnosing aortic dissection, but for evaluation of the entry, extension of the dissection, and involvement of major branches of the abdominal aorta and for a follow-up study. (author)