Preliminary Diagnosis: Cholesterol Emboli Syndrome

I. What imaging technique is first-line for this diagnosis?

  • CT with intravenous contrast

II. Describe the advantages and disadvantages of this technique for diagnosis of cholesterol emboli syndrome.

Advantages

  • Specific to identify calcified and soft plaque using thin slices and reconstructions

  • Relatively inexpensive

    Continue Reading

  • Quick procedure

  • Can visualize complications including aneurysm, rupture, dissection, penetrating ulcer

  • In patients with atheroembolic phenomena, CT is useful to look for a source and provide an assessment of the extent of atherosclerosis.

Disadvantages

  • May underestimate amount of disease

III. What are the contraindications for the first-line imaging technique?

Relative contraindication includes exposure to ionizing radiation during pregnancy.

IV. What alternative imaging techniques are available?

  • MRI

  • Echocardiogram

  • Angiogram

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of cholesterol emboli syndrome.

MRI
Advantages

  • A mural thrombus causes irregularity of aorta

  • Able to visualize complications including aneurysm, dissection, and rupture

Disadvantages

  • Expensive

  • Time consuming

  • Requires significant patient cooperation to minimize artifact

Echocardiogram
Advantage

  • Can assess for emboli from the heart

Disadvantage

  • Limited assessment of only the heart

Angiogram
Advantages

  • Can clearly see mural thrombus, narrowing, and flow dynamics

  • Can intervene in real-time when appropriate

Disadvantages

  • Expensive

  • Associated risks with invasive procedure

  • Exposure to ionizing radiation

VI. What are the contraindications for the alternative imaging techniques?

MRI

Absolute contraindication in patients with non-MR-compatible hardware

Echocardiogram

No significant contraindications

Angiogram

Relative contraindications include pregnancy

Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.

No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.

Jump to Section