Kenneth Shelton, MD, is a critical care physician and cardiothoracic anesthesiologist in the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital and the medical director of the Mass General Corrigan Minehan Heart Center Intensive Care Unit.
Your Thoracic Aortic Center doctor will determine the most appropriate imaging study to document the location of your aneurysm and allow us to measure its size accurately.
Sometimes more than one type of imaging study is needed in order to fully reveal the aortic anatomy. The following are brief descriptions of each of the imaging techniques that might be used:
- CT scans (computed tomography) - produce excellent images of the aorta. For patients with complex aortic anatomy, our computers create a 3-dimensional CT scan image of the entire aorta, which we can then view from all angles. This makes it easier to accurately measure the size of aneurysms and to plan surgery when it is needed.
- MRI (magnetic resonance imaging) - produces images of the aorta from different angles, though the images are not always as sharp as those produced by CT scanning. MRI is often used as an alternative to CT scanning when patients have kidney failure or an allergy to the IV dye (contrast material) needed for CT scanning.
- MRA (magnetic resonance angiography) - a fancier type of MRI that uses a special non-toxic type of dye (contrast material) called gadolinium, which is safe for the kidneys. MRA is used when we need to examine the branch vessels that come off the aorta, and MRA can also produce 3-dimensional images of the aorta.
- Contrast angiography - a more traditional and invasive procedure, is performed only in selected cases, and usually only for a pre-operative evaluation in patients with unusually complex aortic anatomy.
- Transesophageal echocardiography (TEE) - a special type of ultrasound that uses sound waves to image the aorta. However, instead of sending sound waves into the body from the surface of the skin, this procedure sends the sound waves from a thin plastic tube inserted into the patient’s esophagus or swallowing tube. This is especially effective because the esophagus lies right next to the aorta, so the TEE ultrasound images of the aorta are typically very clear.
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