ArticleInvestigative radiology2026
Spectral Computed Tomography for the Detection and Characterization of Communications Between the True and the False Lumen in Aortic Dissections.
Article in Investigative radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo compare the performance of conventional CT (conv-CT) and spectral CT (spectral-CT) for the detection and characterization of communications between the true (TL) and false lumen (FL) in aortic dissections, using 4D flow MRI as the reference. MATERIALS AND
methodsEighteen patients with type A and type B aortic dissection who underwent 4D flow MRI, conv-CT and spectral-CT were retrospectively analyzed. For each patient, the examinations closest in time, without any intervention in-between, were retrieved and subjectively analyzed by 2 observers, independently for conv-CT and in consensus for MRI and spectral-CT. Communications between the two lumina were identified as: focal alterations in velocities corresponding to jet flows on 4D flow; both intimal tears and/or focal changes of contrast concentration corresponding to jet flows on conv-CT and spectral-CT. The number and location of communications were noted. The direction of the flow was assessed whenever the jet flow was visible. The performance of conventional and spectral-CT was calculated.
resultsOf the 176 communications detected with 4D flow, spectral-CT allowed visualization of 122(69%) compared with 58 (33%) for observer-1 and 38 (22%) for observer-2 for conv-CT, yielding an accuracy twice as high (63% vs 29% to 30%).Only jet flows, without visible intimal tears, were detected in 0 and 77 (63%) cases for conv-CT and spectral-CT, respectively.The flow was unidirectional FL-TL in 2 cases for MRI and spectral-CT and 1 case for conv-CT, bidirectional in 5 and 3 cases for MRI and spectral-CT, respectively. In all other cases, the direction was TL-FL.
conclusionSpectral-CT outperformed conv-CT for the detection of communications between TL and FL in aortic dissections. Spectral-CT allowed for direct visualization of flow jets, and their direction, through intimal tears.
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