Computed Tomography Imaging Findings of Acute Aortic Pathologies

Figure 1. Type B Aortic Dissection Axial oblique (A) and coronal oblique (B) reformats and 3D volume rendering image of thoracic CT angiography images demonstrate Stanford type B thoracic aortic dissection (arrow) and rupture, with left hemothorax, pleural effusion, and near complete atelectasis of the left lung (star).

Figure 2. Type A Aortic Dissection A. Axial contrast-enhanced CT image demonstrating an intimal flap (arrows) consistent with a Stanford Type A dissection with extension into the distal thoracic aorta. B. 3D volume rendering image of the thoracic aorta visualization of the type A dissection (arrows). C. Sagittal reformat image shows the extension of the intimal flap into the abdominal aorta (arrows). The false lumen hypoattenuating as compared to the true lumen.

Figure 3. Intramural Hematoma A. Intramural hematomas is visualized as a crescent-shaped or ring like hyperdensity on non-contrast enhanced CT imaging. B. Contrast-enhanced CT demonstrates crescent-shaped hypoattenuation, not to be confused with atherosclerotic thrombus.

Figure 4. Aortic Dissection Spiraling Spiral course of the dissection flap of the aorta is seen in the sagittal reformat image.

Figure 5. Penetrating Atherosclerotic Ulcer Axial image (A) and coronal reformat (B) of the contrast-enhanced CT demonstrate an atheromatous plaque in the abdominal aorta extending beyond the intima into the aortic media. PAU will increase the patient’s risk of intramural hemorrhage, pseudoaneurysm, or dissection formation.