Three-dimensional Imaging Enhances Our Understanding of Aortic Conditions

Moser_112x127By G. William Moser, CRNP
Cardiovascular imaging, especially imaging of the aorta, lends itself extremely well to advanced three-dimensional reconstruction. Two-dimensional X-rays, ultrasound images and others are processed and reconstructed with color, shading and depth. These techniques enable very precise measurements of blood vessels to aid physicians in providing accurate diagnosis as well as planning and performing treatments—both surgical and non-surgical. They allow us to measure morphological contours, volumes and surfaces to a degree not previously possible.

A variety of 3-D imaging tools are available to physicians to reconstruct diagnostic images of the aorta—whether those images are CT scans, MRI/MRA scans or ultrasound. Each of the reconstruction tools has its own strengths—from ease of use, to resolution, to cost and availability. Factors such as the patient’s ability to tolerate contrast media, ability to remain still for longer periods of time—such as with MRI—and surgical history also influence which imaging tool is used.

Reconstruction of aortic root and valve from CT scan using M2S software. White indicates calcification.
Reconstruction of aortic root and valve from CT scan using M2S software. White indicates calcification.
Three-dimensional image reconstruction tools are the backbone of the latest treatment advances for cardiovascular disease. For example, transcatheter aortic valve replacement (TAVR), which is revolutionizing the treatment of aortic valve disease, would essentially be impossible without advanced imaging capabilities. ECG gating, in particular, now allows CT angiography and 3-D reconstruction of the aortic root undisturbed by motion artifacts; 3-D imaging also allows for much more accurate sizing of the replacement aortic valve. Aortic aneurysm treatment with endovascular therapy is also made possible by this imaging technology. Rapid diagnosis and treatment of stroke have also dramatically advanced thanks to these sophisticated diagnostic techniques.

As an added bonus, these techniques also improve patient communication. It’s important that patients understand their condition and any treatment they’re receiving—yet they often have difficulty interpreting scans. Three-dimensional imaging helps us demonstrate aortic issues such as aneurysm in a way that is layperson-friendly, helping medical professionals to show the patient exactly what is wrong and where. For diagnosis, treatment and education, these advanced technologies are worth far more than a thousand words.