February 2015

The considerable advances in diagnostic imaging techniques have greatly increased our understanding of thoracic aortic diseases. The availability, cost/benefit ratio, and additive value of each technique determine its indications. TTE continues to be the technique most used in clinical practice for aortic root assessment. CT has the advantage of its high-resolution assessment of the entire aorta and excellent accuracy on size measurements. MRI offers the greatest morphologic and dynamic information of the aorta without radiation, although in clinical practice it is less commonly available. New advances such as time-resolved 3D phase-contrast velocity (four-dimensional flow) on MRI, electrocardiographically gated MDCT, and the use of contrast in echocardiographic studies, will permit further improvement in the definition of biomechanical properties of the diseased aorta wall, which can be expected to influence the prognostication and management of patients with aortic diseases.