Spectrum of Aortic Pathologies and Incidental Thoraco-Abdominal Findings on CT Aortography: A Retrospective Imaging Study

Abstract

Background and Objective:  To determine the frequency of aortic pathologies detected on CT aortography and to evaluate their association with cardiovascular findings and incidental thoraco-abdominal findings. Materials and Methods: This retrospective cross-sectional imaging study was conducted in the Department of Radiology, Shifa International Hospital, Faisalabad, over a six-month period. Thirty-three patients who underwent contrast-enhanced CT aortography were enrolled using non-probability consecutive sampling. Aortic pathologies (aneurysm, dissection, coarctation, atherosclerosis, Takayasu arteritis), cardiovascular findings, and incidental thoraco-abdominal findings were recorded from PACS and hospital records. Data were analyzed in SPSS; because most contingency tables had expected cell counts below five, Fisher's exact test was used as the primary test of association, with significance set at p≤0.05. Results: Aneurysm was the most frequent pathology (72.7%, n=24), followed by atherosclerosis (63.6%, n=21) and aortic dissection (36.4%, n=12); coarctation (12.1%) and Takayasu arteritis (15.2%) were uncommon. Aneurysm was significantly associated with aortic regurgitation (p=0.032), aortic stenosis (p=0.012), bicuspid aortic valve (p=0.047), and thrombus (p=0.047). Aortic dissection was significantly associated with aortic regurgitation (p=0.001) and aortic stenosis (p=0.010). Atherosclerosis was significantly associated with aortic regurgitation (p=0.016) and aortic stenosis (p=0.010), with lower rates of both compared with non-atherosclerotic aortas. No aortic pathology was significantly associated with any incidental thoraco-abdominal finding (all p>0.05). Conclusion: Aneurysm, atherosclerosis, and dissection accounted for most aortic pathology detected on CT aortography in this referral population and were significantly linked to valvular and thrombotic cardiovascular abnormalities. Incidental thoraco-abdominal findings were common but not pathology-specific, supporting systematic extravascular review on every CT aortography study regardless of the underlying aortic diagnosis.