RadteraCTA Aorta (Chest/Abdomen/Pelvis)
CTA+ ContrastVascular
Indications
- Aortic aneurysm evaluation/surveillance
- Acute aortic syndrome: dissection, intramural hematoma, penetrating ulcer, rupture
- Pre/post EVAR/TEVAR planning and endoleak surveillance
- Vasculitis, traumatic aortic injury
Patient prep
- 18-20G IV antecubital
- Assess renal function (non-emergent)
- ECG gating for thoracic aorta/root reduces pulsation artifact
- Arms up; supine
Contrast
Agentiodinated (iohexol 350 / iopamidol 370)
RouteIV
Dose80-120 mL at 4-5 mL/s + saline chase
TimingBolus tracking in descending thoracic aorta (~100-150 HU trigger); non-contrast (for IMH/dissection/endoleak baseline), arterial, +/- delayed/venous (~60-90 s) phase for endoleak
Technique
- Supine, arms up; coverage thoracic inlet through common femoral arteries (groins) for EVAR access planning
- 120 kV (100 kV thin patients); dose modulation
- ECG-gating for ascending aorta/root (aneurysm, dissection involving root, pre-TAVR)
- Sub-mm collimation, 0.625-1 mm recon
- Non-contrast often included to detect intramural hematoma and as endoleak baseline; delayed phase for endoleak detection
Series / Sequences
| # | Series / Sequence | Plane | Thickness | Notes |
|---|---|---|---|---|
| 1 | Non-contrast axial | axial | 2.5-3 mm | IMH, calcified plaque, endoleak baseline |
| 2 | Arterial axial source | axial | 0.625-1 mm | Thin for 3D/centerline |
| 3 | Delayed axial | axial | 2-3 mm | Endoleak / slow-flow false lumen (when indicated) |
| 4 | Coronal/Sagittal MIP | coronal/sagittal | thick MIP | Aortic morphology |
| 5 | 3D VR + centerline | 3D | VR | Diameters, sizing for stent grafts |
Key points
- Non-contrast phase is essential for intramural hematoma and as endoleak surveillance baseline
- ECG-gate the chest for root/ascending evaluation to eliminate pulsation pseudodissection
- Measure perpendicular to centerline for true aortic diameters
- Cover to femoral arteries for EVAR/TEVAR access route assessment
- Delayed phase improves detection of low-flow (type II) endoleaks
References
• ACR-NASCI-SIR-SPR Practice Parameter for the Performance of Body CTA
• ACR Appropriateness Criteria: Suspected Acute Aortic Syndrome / Abdominal Aortic Aneurysm Follow-up
• Radiopaedia: CT angiography of the aorta ( link
• ACR Appropriateness Criteria: Suspected Acute Aortic Syndrome / Abdominal Aortic Aneurysm Follow-up
• Radiopaedia: CT angiography of the aorta ( link
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.