Aortic dissection 要用什麼檢查？

CTA, MRA, and TEE are all highly sensitive and specific modalities for diagnosing aortic dissection. Therefore, the condition of the patient, the information needed, and the resources and expertise immediately available should drive the choice of study. MRA is considered the gold standard diagnostic study and is the preferred modality for hemodynamically stable patients with suspected aortic dissection. Because of slow data acquisition and the inaccessibility of patients in the scanner, it is generally unsuited for unstable patients, including those with ongoing pain. Bedside TEE is an excellent choice for patients who are too unstable for MRA but is less effective at visualizing distal dissections. Arch aortography is generally reserved for the confirmation of questionable diagnoses or to image specific branch arteries.

簡單說：

• 病人穩定：MRI 是金標準。
• 病人不穩定：CTA 是金標準。
• 病人不穩定又不能做CTA時：TEE是金標準。
• CTA較難看清楚的地方(尤其是分枝處)：用aortogram來輔助。

很棒的全文：
http://www3.interscience.wiley.com/cgi-bin/fulltext/112585678/PDFSTART