What imaging study should be performed for patients with concerning histories of aortic dissection?

In patients with concerning histories of aortic dissection, a CT scan is the most appropriate imaging study. This is largely due to its ability to rapidly and accurately visualize the aorta and any potential pathologies associated with dissection. A CT scan, particularly with contrast, offers high sensitivity and specificity for detecting aortic dissection and provides detailed information about the extent of the dissection and involvement of other structures.

X-rays, while commonly used for initial imaging, contribute limited information regarding the aorta’s condition and are not definitive for diagnosing an aortic dissection. They may sometimes show indirect signs such as a widening of the mediastinum, but they cannot confirm the diagnosis.

Ultrasound can be useful in some contexts, particularly for its portability and ability to visualize the heart and large vessels, but it is less effective in evaluating the thoracic aorta compared to CT. It is often utilized in emergency settings for specific scenarios but falls short in providing detailed anatomic information needed in cases of suspected dissection.

MRI is excellent for soft tissue evaluation and provides detailed images of the aorta without radiation exposure, making it valuable in certain patient populations. However, due to longer acquisition time and concerns regarding patients with certain devices or conditions, it is not