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Aortic Dissection

CT Features that Distinguish True Lumen from False Lumen

¹ Department of Radiology, University of Michigan Health Center, Box 0030, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0030.
² Zuedema Program for Surgical Core Outcomes Research and Evaluation, University of Michigan Health Center, Ann Arbor, MI 48109.
³ Department of Surgery, Section of Cardiothoracic Surgery, University of Michigan Health Center, Ann Arbor, MI 48109.

View larger version (111K): [in a new window]   Fig. 1. —41-year-old man with acute aortic dissection. CT scan obtained at one-quarter distance along length of dissected portion of aorta shows descending aortic dissection flap (arrows) that is curved toward false lumen (F). Beak sign (arrowheads) is present in false lumen. Note that false lumen area is larger than true lumen area.

View larger version (103K): [in a new window]   Fig. 2. —51-year-old woman with chronic aortic dissection. CT scan obtained at one-half distance along length of dissected portion of aorta shows flat dissection flap. False lumen beaks are filled with lowattenuation thrombus (arrowheads). Faintly visualized cobweb (arrows) is present in false lumen (F).

View larger version (135K): [in a new window]   Fig. 3. —65-year-old woman with chronic aortic dissection. CT scan obtained at one-quarter distance along length of dissected portion of aorta shows flat dissection flap. Outer wall calcification (straight arrow) is present in true lumen (T). Thrombus (arrowheads) is present in false lumen. Curved arrow indicates thrombus within false lumen beak.

View larger version (163K): [in a new window]   Fig. 4. —76-year-old man with chronic aortic dissection. CT scan obtained at three-quarters distance along length of dissected portion of aorta shows flat dissection flap. Outer wall calcification (arrows) and thrombus (asterisk) are present in false lumen (F). T = true lumen.

View larger version (144K): [in a new window]   Fig. 5. —59-year-old man with chronic aortic dissection. CT scan obtained at one-quarter distance along length of dissected portion of aorta shows flat dissection flap. Eccentric flap calcification (arrow) is present along true lumen side of flap. Notice that false lumen (F) contains thrombus (arrowheads) and is larger than true lumen at this level.

View larger version (147K): [in a new window]   Fig. 6. —65-year-old man with acute aortic dissection. CT scan obtained at one-quarter distance along length of dissected portion of aorta shows dissection flap that is curved toward true lumen. Anterior false lumen beak (arrowheads) is partially opacified and partially filled with thrombus. F = false lumen.

View larger version (132K): [in a new window]   Fig. 7. —69-year-old woman with acute aortic dissection. CT scan obtained at level of transverse aortic arch shows that outer false lumen (F) wraps around inner true lumen (T). Dissection flap extends into innominate artery. Note cobweb in false lumen (arrow) and bilateral pleural effusions (P).

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