Aortography involves placement of a

catheter In medicine, a catheter ( ) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. ...

in the

aorta The aorta ( ; : aortas or aortae) is the main and largest artery in the human body, originating from the Ventricle (heart), left ventricle of the heart, branching upwards immediately after, and extending down to the abdomen, where it splits at ...

and injection of contrast material while taking

X-ray An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...

s of the

. The procedure is known as an aortogram. The diagnosis of

aortic dissection Aortic dissection (AD) occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart. In most cases, this is associated with a sudden onset of agonizing ches ...

can be made by visualization of the intimal flap and flow of contrast material in both the true lumen and the false lumen. The catheter has to be inserted through the right

femoral artery The femoral artery is a large artery in the thigh and the main arterial supply to the thigh and leg. The femoral artery gives off the deep femoral artery and descends along the anteromedial part of the thigh in the femoral triangle. It enters ...

, because in about two-thirds of cases the aortic dissection spreads into the left

common iliac artery The common iliac artery is a large artery of the abdomen paired on each side. It originates from the aortic bifurcation at the level of the 4th lumbar vertebra. It ends in front of the sacroiliac joint, one on either side, and each bifurcates ...

. The aortogram was previously considered the gold standard test for the diagnosis of aortic dissection, with a sensitivity of up to 80% and a specificity of about 94%. It is especially poor in the diagnosis of cases where the dissection is due to

hemorrhage Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, ...

within the media without any initiating intimal tear. The advantage of the aortogram in the diagnosis of aortic dissection is that it can delineate the extent of involvement of the aorta and branch vessels and can diagnose

aortic insufficiency Aortic regurgitation (AR), also known as aortic insufficiency (AI), is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. As a conse ...

. The disadvantages of the aortogram are that it is an invasive procedure and it requires the use of iodinated contrast material. Aortography has largely been replaced by the diagnostic tools of

MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and rad ...

, CT, and

transesophageal echocardiography A transesophageal echocardiogram (TEE; also spelled transoesophageal echocardiogram; TOE in British English) is an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into th ...

(TEE) all of which have high sensitivities. TEE is favored in emergency situations, as it is relatively non-invasive and a rapid procedure (more so than MRI, which can take hours).

References

External links

* {{Medical imaging Projectional radiography Aorta