Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Extract

A 52-year-old man is sent for a transoesophageal study (TOE) to evaluate his mitral valve. He has a history of end stage renal disease, coronary disease, left ventricular dysfunction, and extensive vascular disease including a Type B aortic dissection, endovascular repair of an abdominal aortic aneurysm, and peripheral vascular disease. Towards the end of the TOE, as the probe was being pulled out, a deep, penetrating ulcer (PU) was noted in the descending thoracic aorta at the level of the main pulmonary artery (Panels 1A and B, arrow). A four-beat narrow-angle 3D acquisition of this region revealed an ulcer with extensive calcification (Panel 2 A, arrows). Transillumination (TruView) of the PU accentuated the calcified areas (Panel 2B) and depth of the ulcer crater (asterisk). Computed tomography (CT) demonstrated the PU with calcified aortic walls (Panels 3A and B, arrows). Note that Panels 3A and B on CT correspond with Panels 1 A and B on TOE, respectively. The area of calcification on the surface of the reconstructed aorta on CT (Panel 4A) denotes the PU. When the wall of the aorta was cropped into (Panel 4B) or the rendered aorta was entered from the caudal end to visualize the inside of the aorta (Panel 5), the PU was noted to look identical to the image captured on 3D. Note the singular piece of calcium (yellow arrow, Panels 2A, B, 4B, and 5) which is seen on both the 3D and CT images. This is an unusual case of a PU with excellent correlation of PU appearance between CT and 3D conveying the added insight provided by 3D echocardiography in this case.

Topic:
Issue Section:
IMAGE FOCUS
You do not currently have access to this article.
Download all slides