Comprehensive reporting of acute aortic syndromes: a practical approach for radiologists

Acute aortic syndromes (AAS) are a group of aortic pathologies with high morbidity and mortality. In the emergency setting, an accurate diagnosis is usually achieved by aortic computed tomography angiography (CTA). Recently, reporting and management guidelines have evolved due to modifications in surgical techniques and the expansion in utilization of endovascular techniques. This being said, radiologists require a more in-depth knowledge of key points to report to surgeons, their clinical implications, and some insights into available imaging-guided treatment options. Given the urgent nature of AAS, the need for rapid, detailed, and standardized reporting is crucial. In this review, we aim to introduce a step-by-step approach to accurate reporting of AAS, discussing recent guidelines and the role of imaging in the preprocedural evaluation of each disease entity (namely, intramural hematoma, penetrating aortic ulcer, and aortic dissection). Additionally, we will highlight the role of key imaging findings in the management of each disease entity. KEY POINTS: Question Acute aortic syndromes require rapid, sufficiently detailed, and accurate diagnosis to allow for timely patient management. Findings In this article, we propose a step-by-step approach using a structured reporting checklist. Clinical relevance Using a stepwise approach will allow timely reporting, give important details, and help guide further patient care.