Thoracic aorta

Diseases of the thoracic aorta are a significant cause of morbidity and mortality and can result in potentially catastrophic consequences, if the condition remains undiagnosed. Conventional digital subtraction angiography (DSA) has been the gold standard for imaging the thoracic aorta for many years; however, this is associated with well-recognized complications due to its invasive nature and is essentially a projectional two dimensional technique, thus providing only limited information about vessel morphology. DSA also uses ionizing radiation and potentially nephrotoxic-iodinated contrast. DSA is now primarily used for guiding interventional procedures, such as stent graft placement, and is occasionally employed as a diagnostic tool in the setting of trauma. Computed tomography (CT) is now the most frequently utilized modality for evaluating the thoracic aorta and has high diagnostic accuracy for detection of aortic pathology, particularly with the advent of multidetector scanners. CT has the advantage of being quick and readily available in most hospital settings; however, it too employs ionizing radiation and potentially nephrotoxic contrast agent.