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Circumferential aortic dissection
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  1. N A Choh1,
  2. S A Choh2,
  3. B Naikoo3,
  4. S A Bhat1,
  5. M Jehangir1
  1. 1
    Department of Radiology, SMHS Hospital, Srinagar, India
  2. 2
    Department of Pediatrics, SKIMS, Soura, Srinagar, India
  3. 3
    Department of Cardiology, SMHS Hospital, Srinagar, India
  1. suhilchoh{at}rediffmail.com

https://doi.org/10.1136/bcr.2008.139758

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    An adolescent otherwise healthy male presented with acute onset chest pain. Physical examination was remarkable for early diastolic murmur of aortic regurgitation. Transthoracic and subsequently transoesophageal echocardiography revealed aortic dissection extending to the arch. CT angiography revealed a circumferential type of aortic dissection extending from the aortic root to the arch (type A) with extension of the dissection flap into the right brachiocephalic artery (fig 1).

    Figure 1
    Figure 1 Enhanced CT shows an intimal flap in the ascending aorta.

    DISCUSSION

    The typical aortic dissection appears on contrast enhanced CT as an intimal flap that separates the false from the true lumen. Features indicative of a true lumen are outer wall calcification and eccentric flap calcification; beak sign, larger cross sectional area and slow enhancement are indicators of a false lumen.1–4 In some instances, an atypical configuration of intimal flap is encountered. These include a calcified false lumen in chronic cases, an aorta with three or multiple channels, an extremely narrow true lumen, or rarely, as in the present case, a circumferential intimal flap.1 3 The latter may be further complicated by intimointimal intussusception, although this was not evident in our case.5

    Acknowledgments

    This article has been adapted from Choh N A, Choh S A, Naikoo B, Bhat S A, Jehangir M. Circumferential aortic dissection Archives of Disease in Childhood 2008;93:581

    REFERENCES

    1. ↵
      1. Sebastia C,
      2. Pallisa E,
      3. Quiroga S,
      4. et al
      . Aortic dissection: diagnosis and follow-up with helical CT. Radiographics 1999; 19(1): 45–60.
      OpenUrlPubMedWeb of Science
      1. Pineiro DJ,
      2. Bellido CA
      . Images in clinical medicine: circumferential dissection of the aorta. N Engl J Med 1999; 340(20): 1553.
      OpenUrlCrossRefPubMedWeb of Science
    3. ↵
      1. Lepage MA,
      2. Quint LE,
      3. Sonnad SS,
      4. et al
      . Aortic dissection: CT features that distinguish true lumen from false lumen. AJR Am J Roentgenol 2001; 177(1): 207–11.
      OpenUrlPubMedWeb of Science
    4. ↵
      1. Fisher ER,
      2. Stern EJ,
      3. Godwin JD 2nd,
      4. et al
      . Acute aortic dissection: typical and atypical imaging features. Radiographics 1994; 14(6): 1263–71.
      OpenUrlPubMedWeb of Science
    5. ↵
      1. Nelson KM,
      2. Spizarny DL,
      3. Kastan DJ
      . Intimointimal intussusception in aortic dissection: CT diagnosis. AJR Am J Roentgenol 1994; 162: 813–14.
      OpenUrlPubMedWeb of Science

    Footnotes

    • Competing interests: None.