16
Assessment
Table 4. Essential Elements of CT and MRI Aortic Imaging
Reports
1. Maximum aortic diameter at each level of dilation, perpendicular to the axis of
blood flow. In cases of asymmetric or oval contour, the longest diameter and its
perpendicular diameter should be reported. Standard measurement levels may be
included, even when normal.
2. Wall changes suggestive of atherosclerosis, diffuse thickening (eg, aortitis), or mural
thrombus.
3. Evidence of luminal stenosis/occlusion, including location, severity, and length.
4. Findings suggestive of acute aortic syndrome (eg, communicating dissection,
intramural hematoma, penetrating atherosclerotic ulcer, focal intimal tear), including
proximal/distal extension (Figure 7), suspected entry tear site (if visible), and
complications (eg, active contrast extravasation, rupture, contained rupture, rupture
including periaortic hemorrhage, pericardial and pleural fluid, mediastinal stranding ).
5. Extension of aortic disease process (acute or chronic) into branch vessels, findings
suggestive of end-organ injury, and suspected malperfusion.
6. Direct comparison with previous examinations should be detailed to identify
pertinent changes.
7. Presence and extent of repair (eg, interposition gra, endovascular stent gra), as well
as any evidence of complication.
8. Impression regarding disease classification (eg, acute aortic syndrome, aneurysm/
pseudoaneurysm, luminal stenosis, atherosclerotic aortic disease).
9. Relevant details regarding method of image acquisition (eg, use of
electrocardiographic-gating and phase of acquisition) and measurement (eg, axial
versus double oblique, inner-edge versus outer-edge) should be included.
