Aortic dissection confirmed, arising from the ascending aorta (Stanford type A) above the sinotubular junction and terminating in the left CIA. Extension of the dissection into the brachiocephalic trunk, left CCA and possibly the coeliac trunk. The coronary artery origins are normal.
The true lumen (more dense) supplies the coeliac trunk, SMA and bilateral renal arteries.
The false lumen (less dense) supplies the IMA.
No renal or splenic infarct but the left kidney density is reduced suggesting reduced perfusion.