CTICasesType A Aortic Dissection with PA Adventitial Hematoma
Imaging findings
CT angiography shows a Stanford Type A aortic dissection extending to the aortic root. A characteristic crescentic soft tissue density (adventitial hematoma) is noted wrapping around the main and right pulmonary arteries, representing hemorrhage dissecting into the shared adventitia.
Key takeaways
Because the ascending aorta and main pulmonary artery share a common adventitial sheath, hemorrhage from an ascending aortic dissection can dissect directly into the adventitial space of the pulmonary artery. This adventitial hematoma should not be misdiagnosed as pulmonary embolism, and is a strong sign of impending aortic rupture.
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