Diagnosis of Dissection of the Coronary Artery Dissection by Multidetector Computed Tomography: A Comparative Study With Coronary Angiology

摘要

Dissection of the coronary artery (DCA) is not only a rare but challenging clinical condition with high mortality rate, which frequently presents as an acute coronary syndrome. It can be divided into spontaneous DCA and secondary DCA, which is caused by hemorrhage within the vessel wall, leading to the separation of vessel layers. An intimal rupture may precipitate bleeding into the wall with free communication between the true and false lumens. Alternatively, rupture of the vasa vasorum may generate a wall hemorrhage without communication with the lumen. The compromise of the true lumen can cause myocardial ischemia. Currently, optical coherence tomography and intravascular ultrasound (IVUS) have replaced coronary angiology (CAG) and became the new "gold standard" for DCA evaluation, but they are all expensive and invasive techniques on the basis of percutaneous coronary intervention and are not without risk. A cost-effective and noninvasive method is, therefore, warranted to detect, monitor, and follow up this entity. Multidetector computed tomography (MDCT)