Dynamic Imaging Features of Retrospective Cardiac Gating CT Angiography Influence Delayed Adverse Events in Acute Uncomplicated Type B Aortic Dissections

To investigate the correlation between dynamic morphological parameters of retrospective cardiac gating ct angiography (cta) and delayed adverse event (dae) in uncomplicated type b acute aortic dissection (utb-aad) patients.

Eighty-seven patients initially diagnosed with utb-aad were retrospectively reviewed. dynamic variables obtained by dose-regulated retrospective cta were recorded, including the minimum relative true lumen diameter (rtla), ratio of the minimum to maximum true lumen relative area (r-rtla), the maximum diameter of the descending aorta, false lumen, and primary entry tear. outcome analysis comprised incidences of dae and early mortality within 3 to 14 days since symptom occurring.

Twenty-six patients (29.9%) developed dae, and two of which (7.7%) died before any interventions. smaller values of rtla (p = 0.01) and r-rtla at the upper thoracic descending aorta (utda) (p < 0.001), and r-rtla at the renal artery level (p = 0.016) demonstrated higher incidences of dae; maximum diameter of the descending aorta (p < 0.001), the false lumen (p = 0.008), and entry tear size (p = 0.007) were positively associated with the occurrence of dae. r-rtla at the utda level yielded the highest diagnostic accuracy (82.0%) in detecting dae at an optimal cutoff value of 61.7% (auc = 0.839). performance of dynamic characteristics was superior to static features obtained from single-phase image in the detection of dae (p < 0.001).

Dynamic morphological features of retrospective cardiac gating cta might aid in identifying a high risk of dae in utb-aad patients and guiding early targeted interventions.