Imaging features
In Aortic dissection an intima flap is seen in only 70% of cases.
When there are 2 lumina, these will spiral around each other (figure).
On the left consecutive images are seen of a Type B dissection.
The true lumen is surrounded by calcifications.
The true lumen is smaller, as the false lumen wedges around the true lumen due to permanent systolic pressure (so called Beak-sign).
Thrombus material invariably is located in the false lumen, which enhances later than the true lumen.
When there are 2 lumina, these will spiral around each other (figure).
On the left consecutive images are seen of a Type B dissection.
The true lumen is surrounded by calcifications.
The true lumen is smaller, as the false lumen wedges around the true lumen due to permanent systolic pressure (so called Beak-sign).
Thrombus material invariably is located in the false lumen, which enhances later than the true lumen.
True lumen:
- Surrounded by calcifications (if present)
- Smaller than false lumen
- Usually origin of celiac trunk, SMA and right renal artery
False lumen:
- Flow or occluded by thrombus (chronic).
- Delayed enhancement
- Wedges around true lumen (beak-sign)
- Collageneous media-remnants (cobwebs)
- Larger than true lumen
- Circular configuration (persistent systolic pressure)
- Outer curve of the arch
- Usually origin of left renal artery
- Surrounds true lumen in Type A dissection
 |
| Type B dissection. Green arrow indicates entry. False lumen is indicated by yellow arrows and is seen spiraling around the true lumen. |
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