Imaging the Thoracic Aorta: Anatomy, Technical Considerations, and Trauma

MDCT has become the primary imaging modality for the detection and characterization of thoracic aortic abnormalities. It offers rapid access and quick scanning protocols to triage critically ill patients. The use of ECG-gating allows clear depiction of the coronary artery origins and the structures of the aortic root, including the aortic valve, which are both key structures to evaluate in association with thoracic aortic diseases. Unenhanced scanning improves identification of intramural and extraluminal blood, facilitating the determination of lesion acuity. Concomitant imaging of the abdominal aorto-iliac system is important in the setting of acute aortic syndromes to assess extension into the aorta, iliac arteries and branches, assess for end-organ malperfusion, and determine the adequacy of the delivery route for endografting.