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AORTA AND BRANCHES: An aortic dissection extending from the sinotubular junction to the distal abdominal aorta, 1.1 cm cranial to the aortic bifurcation into common iliac arteries. The false lumen is seen to originate at the rightward aspect of the sinotubular junction, not involving the coronary arteries or aortic sinus. The false lumen courses on the posterior rightward aspect of the aortic arch and anterior leftward aspect of the descending thoracic aorta. An intimal flap with a 13mm defect is noted in the anterior leftward aspect of the true lumen of the ascending aorta. The major aortic arch branches are not involved and opacify normally. Within the thoracic aorta, the false lumen is located on the right.
The celiac trunk, superior inferior mesenteric arteries enhance normally. Two right renal arteries noted (a superior large calibre and a smaller calibre inferior artery) which opacify normally. A single left renal artery opacifies normally. The dissection does not extend into the common iliac arteries. The common iliac opacified normally.
CHEST: No consolidation, pneumothorax, pleural or pericardial effusions.
ABDOMEN AND PELVIS: The liver, gallbladder, spleen, pancreas, adrenals, kidneys and bowel are unremarkable.
SKELETAL: No focal destructive osseous lesions.
CONCLUSION: Stanford Class A and DeBakey type 1 aortic dissection from the sinotubular junction to the terminal aortic bifurcation, the major branches of the aorta are opacified normally and the coronary arteries and sinus are not involved.