Case: Dual Source CT for the evaluation of coronary artery abnormalities previous to reoperation of the aortic arch and known aorta dissection

Case history
73 year old female, length: 169 cm, weight: 60 kg.
Possibly bypass operation, planned reoperation of the aortic arch, status type 1 dissection October 2007. Status after aortic valve replacement.

Diagnosis
Question: coronary artery abnormalities
Unchanged aspect of the dissection with respect to previous scan. Known intramural hematoma in the mediastinum superius. Normal anatomy of the coronaries but some calcifications in the LAD.

Technique
Thoracic aorta was scanned in an ECG gated Flash scan mode, without breath hold.
Average heart rate was 53.

Comments
The need of visualizing coronaries and known Type 1 dissection necessitates the use of ECG gating. This will increase the radiation dose and will make the procedure more difficult to perform. A Flash scan with ECG modulation will give a valuable image quality with the lowest dose and no difficult processing of data (there is no need of ECG editing)! Even the amount of contrast media can be reduced, because of the ultra fast scan time. This case shows the capability of the Dual Source CT and its unprecedented opportunities to get the best diagnostic result.