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Table 14 Recommendations for CMR in thoracic aortic disease

From: Representation of cardiovascular magnetic resonance in the AHA / ACC guidelines

  Classa Levelb Page
Recommendations for acute thoracic aortic disease    
 Urgent and definitive imaging of the aorta using transesophageal echocardiogram, computed tomographic imaging, or magnetic resonance imaging is recommended to identify or exclude thoracic aortic dissection in patients at high risk for the disease by initial screening. I B 43
Recommendations for Takayasu arteritis and giant cell arteritis    
 The initial evaluation of Takayasu arteritis or giant cell arteritis should include thoracic aorta and branch vessel computed tomographic imaging or magnetic resonance imaging to inves- tigate the possibility of aneurysm or occlusive disease in these vessels. I C 28
Recommendations for aortic arch aneurysms    
 For patients with isolated aortic arch aneurysms less than 4.0 cm in diameter, it is reasonable to reimage using computed tomographic imaging or magnetic resonance imaging, at 12- month intervals, to detect enlargement of the aneurysm. IIa C 58
 For patients with isolated aortic arch aneurysms 4.0 cm or greater in diameter, it is reasonable to reimage using computed tomographic imaging or magnetic resonance imaging, at 6-month intervals, to detect enlargement of the aneurysm. IIa C 58
Recommendations for chronic aortic diseases in pregnancy    
 For imaging of pregnant women with aortic arch, descending, or abdominal aortic dilatation, magnetic resonance imaging (without gadolinium) is recommended over computed tomographic imaging to avoid exposing both the mother and fetus to ionizing radiation. Transesophageal echocardiogram is an option for imaging of the thoracic aorta. I C 64
Recommendations for surveillance of thoracic aortic disease or previously repaired patients    
 Computed tomographic imaging or magnetic resonance imaging of the thoracic aorta is reasonable after a Type A or B aortic dissection or after prophylactic repair of the aortic root/ ascending aorta. IIa C 76
 Computed tomographic imaging or magnetic resonance imaging of the aorta is reasonable at 1, 3, 6, and 12 months postdissection and, if stable, annually thereafter so that any threatening enlargement can be detected in a timely fashion. IIa C 76
 If a thoracic aortic aneurysm is only moderate in size and remains relatively stable over time, magnetic resonance imaging instead of computed tomographic imaging is reasonable to minimize the patient’s radiation exposure. IIa C 76
  1. aClass of recommendation
  2. bLevel of evidence