Fleischmann Dominik, Mitchell R Scott, Miller D Craig
Department of Radiology, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA.
Semin Thorac Cardiovasc Surg. 2008 Winter;20(4):340-7. doi: 10.1053/j.semtcvs.2008.11.011.
The development of retrospective electrocardiographic (ECG)-gating has proved to be a diagnostic and therapeutic boon for computed tomography (CT) imaging of patients with acute thoracic aortic diseases, such as aortic dissection/intramural hematoma (AD/IMH), penetrating atherosclerotic ulcer (APU), and ruptured/leaking aneurysm. The notorious pulsation motion artifacts in the ascending aorta confounding regular CT scanning can be eliminated, and involvement of the sinuses of Valsalva, the valve cusps, the aortic annulus, and the coronary arteries in aortic dissection can be clearly depicted or excluded. Motion-free images also allow reliable identification of the site of the primary intimal tear, the location, and extent of the intimomedial flap, and branch artery involvement. ECG-gated CTA also allows the detection of more subtle lesions and variants of aortic dissection, which may ultimately expand our understanding of these complex, life-threatening disorders.
回顾性心电图（ECG）门控技术的发展已被证明对急性胸主动脉疾病患者的计算机断层扫描（CT）成像具有诊断和治疗上的益处，这些疾病包括主动脉夹层/壁内血肿（AD/IMH）、穿透性动脉粥样硬化溃疡（APU）以及破裂/渗漏性动脉瘤。升主动脉中困扰常规CT扫描的明显搏动运动伪影可以消除，并且可以清晰地描绘或排除主动脉夹层中主动脉瓣窦、瓣膜尖、主动脉环和冠状动脉的受累情况。无运动图像还能可靠地识别原发性内膜撕裂的部位、内膜中层瓣的位置和范围以及分支动脉受累情况。ECG门控CT血管造影（CTA）还能检测到主动脉夹层更细微的病变和变异，这最终可能会扩展我们对这些复杂的、危及生命的疾病的认识。
