RadioGraphics, Vol 14, 1263-1271, Copyright © 1994 by Radiological Society of North America

ARTICLES

Acute aortic dissection: typical and atypical imaging features

ER Fisher, EJ Stern, JD Godwin 2nd, CM Otto and JA Johnson
Department of Radiology, University of Washington Medical Center, Seattle.

Acute aortic dissection (AAD) is the most common emergency affecting the aorta. Noninvasive imaging allows prompt and reliable diagnosis of AAD and has largely supplanted aortography. However, atypical imaging features and diagnostic pitfalls can delay lifesaving therapy. An intimal flap is the characteristic feature of AAD. If there is flow within both lumina, typical imaging features are probably present. If the false lumen is thrombosed or there is no intimal tear to permit flow through the false lumen, a distinct intimal flap may not be present. Secondary signs of AAD include an intramural or periaortic acute thrombus, which manifests as a high-attenuation cuff or crescent on unenhanced computed tomographic scans. Other conditions that can reduce the conspicuity of the intimal flap include atypical configurations of the flap, such as seen with short dissections or with multiple false channels, in which case the flaps are complex. Finally, aortic anomalies may cause confusion.

This article has been cited by other articles:

				N A Choh, S A Choh, B Naikoo, S A Bhat, and M Jehangir Circumferential aortic dissection Arch. Dis. Child., July 1, 2008; 93(7): 581 - 581. [Full Text] [PDF]

				H. I. Ha, J. B. Seo, S. H. Lee, J.-W. Kang, H. W. Goo, T.-H. Lim, and M. J. Shin Imaging of Marfan Syndrome: Multisystemic Manifestations RadioGraphics, July 1, 2007; 27(4): 989 - 1004. [Abstract] [Full Text] [PDF]

				S.-F. Ko, M.-J. Hsieh, M.-C. Chen, S.-H. Ng, F.-M. Fang, C.-C. Huang, Y.-L. Wan, and T.-Y. Lee Effects of Heart Rate on Motion Artifacts of the Aorta on Non-ECG-Assisted 0.5-Sec Thoracic MDCT Am. J. Roentgenol., April 1, 2005; 184(4): 1225 - 1230. [Abstract] [Full Text] [PDF]

				E. Castaner, M. Andreu, X. Gallardo, J. M. Mata, M. A. Cabezuelo, and Y. Pallardo CT in Nontraumatic Acute Thoracic Aortic Disease: Typical and Atypical Features and Complications RadioGraphics, October 1, 2003; 23(90001): S93 - 110. [Abstract] [Full Text] [PDF]

				M. A. LePage, L. E. Quint, S. S. Sonnad, G. M. Deeb, and D. M. Williams Aortic Dissection: CT Features that Distinguish True Lumen from False Lumen Am. J. Roentgenol., July 1, 2001; 177(1): 207 - 211. [Abstract] [Full Text] [PDF]

				C. Sebastia, E. Pallisa, S. Quiroga, A. Alvarez-Castells, R. Dominguez, and A. Evangelista Aortic Dissection: Diagnosis and Follow-up with Helical CT RadioGraphics, January 1, 1999; 19(1): 45 - 60. [Abstract] [Full Text] [PDF]

				A. J. Madureira, L. E. Quint, and D. M. Williams Diagnostic Criteria for Intramural Hematoma Drs Quint and Williams respond: Radiology, February 1, 2002; 222(2): 576 - 577. [Full Text] [PDF]