Stanford type B aortic dissection

Case contributed by Chris Newman
Diagnosis certain


Sudden onset chest pain radiating to back.

Patient Data

Age: 50 years
Gender: Male
  • the proximal descending aorta has a double contour and exerts mass effect upon the trachea and left main bronchus, concerning for an acute aortic dissection
  • the lungs and pleural spaces are clear
  • Stanford type B aortic dissection characterized by an intimal thoracic aortic dissection flap originating just distal to the left subclavian artery origin
  • the dissection flap extends into the abdominal aorta and to the level of proximal iliac arteries
  • there is both a true and false lumen. The true lumen is the the smaller of the two, located posteriorly and toward the right within the thorax. The false lumen is the larger of the two, located anteriorly and more toward the left within the thorax
  • the celiac trunk, superior mesenteric artery (markedly thickened and narrowed at the ostium), the left renal artery and the inferior mesenteric artery arise from the true lumen. The right renal artery arises from the false lumen
  • enhancement of the intra-abdominal viscera is preserved

Case Discussion

Typical example of an acute aortic dissection and the features on plain x-ray with a widened mediastinum and thoracic aortic double contour.

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