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158, No. 10, No. Ihre Nachricht wurde jetzt an die PONS-Redaktion übermittelt. TEE can be performed in the emergency department at the bedside of unstable patients, thereby helping prevent delays in accurate diagnosis and treatment. Axial image shows a pericardial recess (arrows) mimicking a dissection flap in the ascending aorta. Transthoracic echocardiography is a noninvasive examination that may help detect an ascending aortic dissection flap. Atypical appearances of an aortic dissection. This type of obstruction is treated with intravascular stent placement. A recent study identified rupture as the cause of death in approximately one-third of affected patients admitted to the hospital, although the rate of nonfatal rupture may be considerably higher (1,2). 1, 17 November 2011 | La radiologia medica, Vol.

Es ist ein Fehler aufgetreten. Understanding acute aortic type B dissection: Are there new horizons in patient selection? 4, British Journal of Hospital Medicine, Vol. Axial (a), coronal (b), and sagittal (c) images show atypical appearances of an aortic dissection, including circumferential dissection of the intimal layer (arrow in b).

59, No. 36, No. Alle Rechte vorbehalten. Viewer, Figure 7 Mercedes-Benz sign. 4.

2, Reviews in Vascular Medicine, Vol. It is important to look at end organs such as the kidneys for evidence of involvement (eg, infarction or ischemia) (Figure 16–Figure 18) (1).Figure 15 Dissection flap near the origin of the superior mesenteric artery. 1, International Journal of Cardiology, Vol. An early diagnosis and treatment appears necessary. Stanford type B aortic dissection. Sagittal (a) and coronal (b) images of the lumbosacral spine show associated marfanoid features of dural ectasia and posterior scalloping of the lower lumbar vertebral bodies and sacrum, along with enlargement of the spinal canal. Figure 19 Axial image shows extension of a dissection flap into the right common femoral artery (arrow). (d, e) On coronal (d) and sagittal (e) maximum intensity projection images obtained in a different patient, the dissection flap arises distal to the left subclavian artery (arrow in e). ECG gating is becoming the standard of care because it allows delineation of the aortic root and visualization of dissection flap involvement of the coronary arteries. (b) Axial image through the thorax shows the dissection flap in the aortic arch. 10, 1 April 2012 | La radiologia medica, Vol. 11, 19 October 2016 | PLOS ONE, Vol. However, misdiagnosis of aortic dissection secondary to motion artifact simulating an intimal flap in the ascending aorta still occurs at nongated 64-detector CT. Aortic motion artifact. False-negative study results can occur due to inadequate contrast opacification caused by cardiac failure (17), or to the thrombosed lumen being mistaken for an aortic aneurysm with mural thrombus. Complications of thoracic aortic dissection.

Aortic root anomalies such as valvular aortic stenosis, coarctation, or bicuspid aortic valves also predispose to the development of dissections. 205, No. Brachiocephalic artery dissection. With respect to iliac and femoral artery involvement, if a percutaneous intervention is being considered, it is important to determine whether the true lumen can be entered with a right or left femoral artery approach.Figure 19 Axial image shows extension of a dissection flap into the right common femoral artery (arrow). 6, 4 August 2014 | Clinical Anatomy, Vol. Mechanical causes (eg, prosthetic valves, blunt trauma, or catheterization) are rare (17). 7, No. If the dissection flap continues into the aortic arch, it tends to lie posterosuperiorly along the convexity. The radiation exposure in retrospectively ECG-gated CT angiography is higher than that in nongated chest protocols (50). Periaortic fibrosis or mediastinal, pulmonary, or retroperitoneal tumors can also be mistaken for dissection flaps, as can anemia with apparent high attenuation of the aortic wall.

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