 Introduction/Background Nontraumatic aortic disease can be caused by a wide variety of disorders, including congenital, inflammatory, infectious, metabolic, neoplastic, and degenerative diseases. Such conditions include, but are not limited to, atherosclerosis, aortic dissection, intramural hematoma, penetrating aortic ulcer, aortic aneurysms of various etiologies (degenerative, mycotic, or vasculitis-related), aortic rupture, thrombosis, aortobronchial fistula, congenital disorders, and extrinsic compression from adjacent masses. Diagnostic imaging is essential to assess the anatomy and extent of morphological changes involving the aorta. Nontraumatic aortic diseases may affect the lumen, wall, or perivascular structures. When there is aortic branch vessel involvement, end organ perfusion may be compromised. Often, aortic disorders involve both the thoracic and abdominal aortic segments, thus requiring imaging of both regions. The clinical symptoms of aortic diseases vary widely. For example, acute aortic syndrome presents acutely with chest pain and elevated blood pressure, whereas atherosclerosis may be asymptomatic and detected incidentally. All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and reconstructions/reformats. Only in CTA, however, is 3-D rendering a required element. This corresponds to the definitions that the CMS has applied to the Current Procedural Terminology codes. aUniversity of Alabama at Birmingham, Birmingham, Alabama. bPanel Chair, Massachusetts General Hospital, Boston, Massachusetts. cPanel Vice-Chair, Emory Healthcare, Atlanta, Georgia. dSt. Francis Hospital, Catholic Health Services of Long Island, Roslyn, New York; Society for Cardiovascular Magnetic Resonance. eTufts University School of Medicine, Boston, Massachusetts; Society for Vascular Surgery.
Nontraumatic Aortic Disease.  Introduction/Background Nontraumatic aortic disease can be caused by a wide variety of disorders, including congenital, inflammatory, infectious, metabolic, neoplastic, and degenerative diseases. Such conditions include, but are not limited to, atherosclerosis, aortic dissection, intramural hematoma, penetrating aortic ulcer, aortic aneurysms of various etiologies (degenerative, mycotic, or vasculitis-related), aortic rupture, thrombosis, aortobronchial fistula, congenital disorders, and extrinsic compression from adjacent masses. Diagnostic imaging is essential to assess the anatomy and extent of morphological changes involving the aorta. Nontraumatic aortic diseases may affect the lumen, wall, or perivascular structures. When there is aortic branch vessel involvement, end organ perfusion may be compromised. Often, aortic disorders involve both the thoracic and abdominal aortic segments, thus requiring imaging of both regions. The clinical symptoms of aortic diseases vary widely. For example, acute aortic syndrome presents acutely with chest pain and elevated blood pressure, whereas atherosclerosis may be asymptomatic and detected incidentally. All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and reconstructions/reformats. Only in CTA, however, is 3-D rendering a required element. This corresponds to the definitions that the CMS has applied to the Current Procedural Terminology codes. aUniversity of Alabama at Birmingham, Birmingham, Alabama. bPanel Chair, Massachusetts General Hospital, Boston, Massachusetts. cPanel Vice-Chair, Emory Healthcare, Atlanta, Georgia. dSt. Francis Hospital, Catholic Health Services of Long Island, Roslyn, New York; Society for Cardiovascular Magnetic Resonance. eTufts University School of Medicine, Boston, Massachusetts; Society for Vascular Surgery.