Long-Term Imaging of the Aorta: Considerations and Comparison of Modalities

Patients with aortic dissection and other acute aortic diseases are subject to long-term imaging surveillance to monitor aortic growth and detect complications. This chapter will focus on practical aspects of long-term aortic imaging, including the selection of imaging surveillance intervals, choice of imaging modality (echocardiography vs. CT vs. MRI) and highlight advantages and weaknesses of various imaging techniques for assessment of aortic disease progression. We will first review published data and recommendations for long-term imaging of acute aortic disease, highlight a variety of modality and patient-specific factors to guide selection of an imaging surveillance strategy, and discuss considerations for imaging surveillance after endovascular aortic repair. Furthermore, we will outline common measurement techniques for assessing disease progression with specific attention on pitfalls and sources of measurement variability, and lastly briefly highlight several emerging image analysis techniques that may improve the accuracy and efficiency of imaging surveillance.