CTICasesPulmonary Artery Dissection
[...]. Pulmonary Artery Dissection. CTICases. Published June 12, 2021. https://str-case-explorer.pages.dev/c/edzgj
Imaging findings
CT pulmonary angiogram in a patient with severe, chronic pulmonary hypertension demonstrates massive aneurysmal dilatation of the main and branch pulmonary arteries. A thin, linear intimal flap is clearly visualized extending across the lumen of the main pulmonary artery trunk, confirming an acute-on-chronic pulmonary artery dissection.
Key takeaways
Pulmonary artery dissection is an extremely rare and highly fatal complication that typically occurs in the setting of severe, long-standing pulmonary arterial hypertension. The chronic high-pressure state and progressive aneurysmal dilatation of the pulmonary trunk lead to wall shear stress and medial degeneration, predisposing to intimal tear and dissection. Prompt recognition of this finding on CT is critical, as it represents a life-threatening cardiovascular emergency that must be distinguished from motion artifacts.
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