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Fig. 4B. —47-year-old man with acute chest pain and type B aortic dissection. Axial enhanced CT scan at level of superior mesenteric artery (SMA) shows distal extension of dissection flap to abdominal aorta and SMA. True (arrow) and false (F) lumens within proximal SMA are patent and show unequal contrast enhancement. Although true obstruction does not exist in this patient, dissection flap has potential of causing mechanical SMA obstruction (static obstruction). Right and left renal arteries (not shown) arise from markedly narrowed true lumen and larger false lumen, respectively. Decreased right renal perfusion is evident by decreased enhancement of right kidney (RK) compared with left kidney (LK). P = pancreas.