[The value of recent non-invasive medical imagings in diagnosis of dissecting aortic aneurysm; further investigation on transesophageal echocardiography and MRI].

The value of non-invasive medical imagings in diagnosis of dissecting aortic aneurysm was evaluated in 23 patients by two-dimensional transesophageal echocardiography (TEE) and in 23 patients by MRI. An intimal flap was demonstrated in all 23 cases by TEE and in 21 of 23 cases (91.3%) by MRI. DeBakey type classification could be recognized in 20 of 23 cases (87.0%) by TEE and in 21 of 23 cases (91.3%) by MRI. The entry of aortic dissection could be identified in 20 of 23 cases (87.0%) by TEE in 9 of 23 cases (39.1%) by MRI. The differentiation between true and false lumen could be performed in all 23 cases by TEE and in 21 of 23 cases (91.3%) by MRI. The capability of TEE to visualize the lesion of descending aorta was superior to any other conventional diagnostic method, however, there were difficulties in scanning the distal part of the ascending aorta and aortic arch. MRI could not detect the small lesion such as entry in almost all cases, but was superior in diagnosis of the lesion of aortic arch and in recognition of the whole imagings. Since transthoracic echocardiography has an additional value in diagnosis of dissecting aortic aneurysm, the diagnostic method of a combination of transthoracic and transesophageal echocardiography seems to be more valuable. We believe that operation could be carried out solely on the basis of diagnosis of dissecting aortic aneurysm by echocardiography in emergency cases.