Type:
Educational Exhibit
Keywords:
Emergency Imaging, Arteries / Aorta, Emergency, Vascular, CT, CT-Angiography, CT-High Resolution, Angioplasty, Arthrography, Stents, Aneurysms, Dissection, Hypertension, Not applicable
Authors:
J. G. Del Aguila Hernández, J. ALFARO, G. Guzman; Guatemala/GT
DOI:
10.26044/ecr2020/C-02473
Background
Acute aortic dissection is the aortic pathology with emergency character, often resulting in the death of the patient, it is important, the radiologist who can interpret the CT in the shortest possible time, in 10 minutes; for that, we need the diagnostic image to be fast and to be available to all emergency places, these features are the CT scan. This has a sensitivity and specificity of nearly 100%. Early diagnosis and treatment are essential for improving the prognosis
The aortic dissection is the result of a spontaneous longitudinal separation of the aortic intima and adventitia caused by circulating blood gaining access to and aplitting the media of the aortic wall.
The clinical manifestations are diverses. The most risk factor for the development of and aortic dissection is hypertension, which occurs in 70% of cases.
The differential diagnosis can be:
-Intramural hematoma: Intramural hematoma is caused by a spontaneous hemorrhage of the vasa vasorum of the media layer, which weakens the media without and intimal tear, it appears as a crescent-shaped area of attenuation in the aortic wall.
Penetrating atherosclerotic ulcer: It is defined as a ulceration of atheromatous plaque that has eroded the inner, elastic layer of the aortic wall, reached the medial layer, and produced a hematoma in the media.
The most commun complications can be, rupture, reentry of dissection hematoma, trombosis, compression and aortic remodeling. The rupture is the most important, because its complication can be quickly deadly. That can be hemopericardium, mediastinal hematoma, hemothorax, cerebral ischemia and obstruction in the main abdominal arterial branches.