Clinical Presentation

A 49-year-old woman has a history of ascending aortic aneurysm repair.

(A) Oblique, coronal reformatting of a contrast-enhanced (CT) scan shows a linear aortic filling defect (large arrow) distal to the lef t subclavian artery (small arrows, tube graft). (B) Oblique, sagittal reformatting shows contrast within the false lumen of a Stanford type B aor tic dissection (arrow). (C) Sagittal reformatting shows supply to the celiac artery by the false lumen (arrow) and supply to the superior mesenteric artery by the true lumen (arrowhead). (D) Three-dimensional volume-rendered posterior image shows the renal arteries filling from the true lumen, just below the lowest point of dissec tion (arrowhead, true lumen; arrow, false lumen).

Differential Diagnosis

• Dissecting aortic aneurysm, Stanford type B

Essential Facts