Pulmonary multislice computed tomography findings in acute aortic dissection

Abstract

Objective: To document the type and incidence of pulmonary multislice computed tomography (CT) findings at presentation in patients with acute aortic dissection.

Materials and methods: Multidetector CT scans of 36 patients with a diagnosis of acute aortic dissection or intramural hematoma were retrospectively reviewed.

Results: Pleural effusion, dependent stasis, mosaic attenuation, interlobular septal thickening, thickening of the peribronchovascular interstitium, vascular enlargement, compression atelectasis were common findings. Additionally air trapping, emphysema, consolidation, nodules, bronchiectasis or scarring were also noted.

Conclusions: Various pulmonary imaging findings may accompany acute aortic dissection. These findings and their clinical significance should be further investigated.

Keywords: Acute aortic dissection; MDCT; computed tomography; lung.

Figure 1

Bilateral pleural effusions, atelectases, and vascular enlargement in a patient with type 3 dissection on day 4 after the onset of symptoms.

Figure 2

Ground glass areas and pleural effusion in a patient with type 2 dissection on the first day of onset of symptoms.

Figure 3

Type 1 dissection on the first day causing subsegmentary atelectases, thickening of the fissures, interlobular septal thickening, and mosaic attenuation. Note sternal sutures due to previous aortic valve replacement surgery. Patient expired 3 hours after this CT scan with respiratory insufficiency and cardiopulmonary collapse.

Figure 4

Type 1 dissection on day 4 with interlobular septal thickening, bilateral pleural effusions, peribronchovascular thickening and vascular enlargement. Note minimal air trapping in left lower lobe posterobazal segment due to compression of segmental bronchus at a more cranial level (not shown) by the tortuous aorta.

Figure 5

Type 3 dissection ruptured into the left pleural space causing total left lung collapse.