- an aortic dissecting intimal flap seen spiraling along the whole aorta extending from its root down to its bifurcation and through into the left common iliac artery (CIA)
- the dissected intimal flap is seen dividing the aortic lumen into false and true lumina, with the false lumen is much larger than, and compromising, the true lumen in the distal aortic arch and the whole descending aorta, while the true lumen is larger in the ascending aorta and almost equal to the false lumen in the proximal arch. The false lumen is not thrombosed. The dissection flap shows two fenestrations at the ascending aorta and another two at the mid arch
- consequent dilatation of the ascending aorta (5 cm in diameter) and the descending thoracic aorta (5.7 X 4.9 cm) is noted
- the narrowest true lumen is seen at D11 level measuring 21.4 X 9.3 mm
- almost all the main branches of the different segments of the aorta arise from the true lumen, except the left CIA which is seen involved by the false lumen with no appreciable dilatation
- no evidence of aortic wall rupture or extra-aortic contrast leak
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evidence of bilateral pulmonary edema with para-cardiac batwing alveolar haze as well as interstitial edema with indistinct vessels and thickened interlobular septa. This is most probably due to pulmonary venous hypertension