Question 198
{"accessible":false,"alternatives":[{"id":955,"text":"CT angiography "},{"id":956,"text":"digital subtraction angiography"},{"id":957,"text":"MR angiography"},{"id":958,"text":"plain radiography"},{"id":959,"text":"transesophageal echocardiography "}],"archived":false,"correctAlternativeId":955,"explanation":"\u003cp\u003eCT, especially with arterial contrast enhancement (CTA) is the investigation of choice, able not only to diagnose and classify the dissection but also evaluate for distal complications. It has reported sensitivity and specificity of nearly 100%.\u003c/p\u003e\u003cp\u003eConventional digital subtraction angiography has historically been the gold standard investigation. CTA has now replaced it as the first line investigation, not only due to it being non-invasive but also on account of better delineation of the poorly opacifying false lumen, intramural hematoma and end-organ ischemia.\u003c/p\u003e\u003cp\u003eHowever, angiography still is required for endoluminal repair.\u003c/p\u003e\u003cp\u003eAortic dissection can also be diagnosed on MRA and transesophageal echocardiography. The diagnosis can only be suggested on plain radiographs with displacement of wall calfication medially.\u0026nbsp;\u003c/p\u003e","id":198,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2658","nextQuestionPath":"/articles/aortic-dissection/questions/197","relatedArticles":[],"alsoUsedIn":[],"stem":"\u003cp\u003eThe most appropriate first-line modality for the diagnosis of aortic dissections is...\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/198"}],"attemptsPercentages":[{"alternativeId":"959","percentage":2},{"alternativeId":"956","percentage":1},{"alternativeId":"958","percentage":7},{"alternativeId":"955","percentage":90},{"alternativeId":"957","percentage":0}],"promptToLogin":false,"questionManager":false,"articleId":"aortic-dissection"}