Bossone E, Suzuki T, Eagle K A, Weinsaft J W
Heart Department, University of Salerno, Salern, Italy.
Herz. 2013 May;38(3):269-76. doi: 10.1007/s00059-012-3710-1. Epub 2012 Dec 23.
Acute aortic syndromes are fatal medical conditions including classic acute aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer. Given the nonspecific symptoms and signs, a high clinical index of suspicion followed by an imaging study, namely transesophageal echocardiography, computed tomography, and magnetic resonance imaging (sensitivity 98-100% and specificity 95-100%), is a conditio sine qua non for prompt diagnosis of acute aortic syndromes. This article provides an overview of established and emerging approaches for the assessment of acute aortic syndromes, with focus on imaging and biomarkers. In this regard, D-dimer levels (cut-off: 500 ng/ml) may be useful to rule out aortic dissection, if used within the first 24 h after symptom onset.
急性主动脉综合征是包括典型急性主动脉夹层、壁内血肿和穿透性动脉粥样硬化溃疡在内的致命性疾病。鉴于其症状和体征不具特异性，高度的临床怀疑指数随后进行影像学检查，即经食管超声心动图、计算机断层扫描和磁共振成像（敏感性98 - 100%，特异性95 - 100%），是快速诊断急性主动脉综合征的必要条件。本文概述了评估急性主动脉综合征的既定方法和新出现的方法，重点是影像学和生物标志物。在这方面，D - 二聚体水平（临界值：500 ng/ml）如果在症状发作后24小时内使用，可能有助于排除主动脉夹层。
