EURORAD ESR

Case 15525

Aortic Dissection in patient with Alpha 1 antitrypsin deficiency.

Author(s)
Dr Abdalazeem Ibrahem
Dr Amjed Eljaili
Dr Usama Afzal Butt
Dr W. Eley
Dr Jaya Iakshmi Vangara
Dr Azad Hanna

Authors institution:-Betsi Cadwaladr university Health Board , Ysbyty Gwynedd , LL57 2PW
 
Patient
female, 53 year(s)
 
 
  • Figure 1
    Figure 1a CTPA, Figure 1b CT Chest
     

    CTPA 1 year ago. Axial slice showing no evidence of pulmonary embolism during the pulmonary arterial phase

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Dilatation;

    Axial non-contrast chest CT section at lung window showing emphysema.

     
    Area of Interest: Lung; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Chronic obstructive airways disease;
     
     
  • Figure 2
    CTA
     

    Axial CTA: dissection is identified in the lower thoracic aorta in a retro-cardiac location.

     
    Area of Interest: Thorax; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Dissection;

    Axial CTA at the level of the origin of the left renal artery showing the dissection flap

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Dissection;

    Axial CTA at upper pelvic level: dissection extends from the abdominal aorta into the left common iliac artery.

     
    Area of Interest: Thorax; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Dissection;

    Coronal CTA reformation: the aorta is measuring approximately 40 mm in maximum short axis diameter at the level of the aortic hiatus of the diaphragm.

     
    Area of Interest: Thorax; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Dissection;

    Axial CTA showing a dilated ascending aorta but no evidence of type A aortic dissection

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Dissection;

    Sagittal CTA reformation showing both the dilated ascending aorta and the dissected abdominal aorta.

     
    Area of Interest: Arteries / Aorta; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Dissection;
     
     
  • Figure 3
    CTPA
     

    Axial slice of CTPA showing a dilated main pulmonary artery. Although the phase is too early for aortography, early filling of the true lumen of aortic dissection can be detected, a finding missed prospectively

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Dissection;

    Axial slice of CTPA at the level of the right diaphragm: the right ventricle is large, and again, dissection of the descending aorta is a faint but obvious finding.

     
    Area of Interest: Thorax; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Dissection;
     
     
CTPA 1 year ago. Axial slice showing no evidence of pulmonary embolism during the pulmonary arterial phase
 
Axial non-contrast chest CT section at lung window showing emphysema.
 
Axial CTA: dissection is identified in the lower thoracic aorta in a retro-cardiac location.
 
Axial CTA at the level of the origin of the left renal artery showing the dissection flap
 
Axial CTA at upper pelvic level: dissection extends from the abdominal aorta into the left common iliac artery.
 
Coronal CTA reformation: the aorta is measuring approximately 40 mm in maximum short axis diameter at the level of the aortic hiatus of the diaphragm.
 
Axial CTA showing a dilated ascending aorta but no evidence of type A aortic dissection
 
Sagittal CTA reformation showing both the dilated ascending aorta and the dissected abdominal aorta.
 
Axial slice of CTPA showing a dilated main pulmonary artery. Although the phase is too early for aortography, early filling of the true lumen of aortic dissection can be detected, a finding missed prospectively
 
Axial slice of CTPA at the level of the right diaphragm: the right ventricle is large, and again, dissection of the descending aorta is a faint but obvious finding.
 
 
 
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