US Echocardiography Transthoracic TTE can view the thoracic aorta (mainly the ascending aorta and, to some extent, the proximal descending aorta and arch) and the aortic valve (for presence and quantification of aortic regurgitation). There is no relevant literature supporting TTE as the initial imaging modality when evaluating infectious, inflammatory, metabolic, or neoplastic processes in the aorta. US Echocardiography Transesophageal TEE may provide views of the descending aorta not appreciated on TTE, but there is no relevant literature supporting TEE as the initial imaging modality when evaluating infectious, inflammatory, metabolic, or neoplastic processes in the aorta. Aortography Chest and Abdomen Aortography no longer has a significant role as the initial imaging modality for suspected degenerative or atherosclerotic disease of the aorta, as the availability and accuracy of noninvasive methods continues to increase. Catheter-based angiography remains a critical component of care when an intervention is planned. Nontraumatic Aortic Disease CTA Chest and Abdomen with IV Contrast CTA with IV contrast is an important tool when evaluating the aorta for suspected degenerative and atherosclerotic changes as it provides information about the aortic lumen, the aortic wall, and surrounding aortic structures [86,87]. CT can also be used to detect other pathologies in the lungs, chest wall, and pleura, which can mimic the symptoms of aortic disease [88]. The addition of a venous phase to the CTA appears to increase its ability to identify both benign and malignant incidental pathology in nonvascular structures. [89]. Electrocardiograph (ECG)-gated aortic CTA decreases pulsation artifacts of the ascending aorta, which allows for a more accurate measurement of the ascending aortic diameter and potentially increases diagnostic confidence [90]. CTA provides information about the aortic root [91], aortic valve area and function, aortic wall elasticity, and morphology in general [92,93].
Nontraumatic Aortic Disease. US Echocardiography Transthoracic TTE can view the thoracic aorta (mainly the ascending aorta and, to some extent, the proximal descending aorta and arch) and the aortic valve (for presence and quantification of aortic regurgitation). There is no relevant literature supporting TTE as the initial imaging modality when evaluating infectious, inflammatory, metabolic, or neoplastic processes in the aorta. US Echocardiography Transesophageal TEE may provide views of the descending aorta not appreciated on TTE, but there is no relevant literature supporting TEE as the initial imaging modality when evaluating infectious, inflammatory, metabolic, or neoplastic processes in the aorta. Aortography Chest and Abdomen Aortography no longer has a significant role as the initial imaging modality for suspected degenerative or atherosclerotic disease of the aorta, as the availability and accuracy of noninvasive methods continues to increase. Catheter-based angiography remains a critical component of care when an intervention is planned. Nontraumatic Aortic Disease CTA Chest and Abdomen with IV Contrast CTA with IV contrast is an important tool when evaluating the aorta for suspected degenerative and atherosclerotic changes as it provides information about the aortic lumen, the aortic wall, and surrounding aortic structures [86,87]. CT can also be used to detect other pathologies in the lungs, chest wall, and pleura, which can mimic the symptoms of aortic disease [88]. The addition of a venous phase to the CTA appears to increase its ability to identify both benign and malignant incidental pathology in nonvascular structures. [89]. Electrocardiograph (ECG)-gated aortic CTA decreases pulsation artifacts of the ascending aorta, which allows for a more accurate measurement of the ascending aortic diameter and potentially increases diagnostic confidence [90]. CTA provides information about the aortic root [91], aortic valve area and function, aortic wall elasticity, and morphology in general [92,93].