CTICasesAcute Type A Aortic Dissection with Displaced Intimal Calcification
Imaging findings
Serial chest radiographs demonstrate new opacity along the aortic arch with displaced intimal calcification, which was not present on prior imaging from 2015. On CT, a clearly visible intimal flap consistent with acute type A aortic dissection is identified. The displaced intimal calcification on the radiograph serves as a classic sign of acute aortic pathology that distinguishes the outer wall of the aorta from the true aortic lumen.
Key takeaways
Displaced intimal calcification on chest radiograph is a classic but uncommon sign of acute aortic dissection, visible when the aortic wall is calcified and a new hematoma or dissection flap displaces the calcification inward from the expected position of the outer aortic contour. Comparison with prior radiographs showing undisplaced calcification is the key to recognizing this finding. This radiographic sign should prompt urgent CT aortography to confirm and characterize the dissection.
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