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Intimomedial Rupture: A New CT Finding to Distinguish True from False Lumen in Aortic Dissection

¹ All authors: Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop St., Pittsburgh, PA 15213.

OBJECTIVE. The purpose of our study is to describe a new imaging finding observed on contrast-enhanced MDCT of discontinuity in the intimomedial flap seen with aortic dissection that may identify the level of intimomedial entrance tear and distinguish true from false lumen.

CONCLUSION. Direct visualization of an intimomedial rupture on MDCT is a valuable cross-sectional imaging sign indicating direction of the intimomedial entrance tear from true to false lumen in cases of aortic dissection. The presence of this finding enables reliable distinction of the true lumen, where the tear is broad-based and erupts into the false lumen, which receives the evaginating tear. Improved scanning techniques through MDCT may have enabled recognition of this relatively infrequent, yet highly specific, finding.

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