CTICasesType B Aortic Dissection with Patent False Lumen
[...]. Type B Aortic Dissection with Patent False Lumen. CTICases. Published April 15, 2021. https://str-case-explorer.pages.dev/c/z3c4k
Imaging findings
Contrast-enhanced CT demonstrates a communicating type B aortic dissection extending into the abdomen with a patent false lumen and true/false lumen separation. There is a projection mimicking a penetrating atherosclerotic ulcer (PAU), but it is located within the dissection flap and is non-hyperattenuating, consistent with chronic dissection changes rather than an acute PAU.
Key takeaways
Assessing acute aortic syndromes on contrast-enhanced CT without a non-contrast scan is challenging, as thrombus or slow flow in a false lumen can be misdiagnosed as an acute intramural hematoma (IMH) or penetrating ulcer. Aortic projections within a chronic dissection template often represent localized communicating false-lumen pouches rather than new penetrating ulcers.
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