CTICasesIntimal tear mimic
Imaging findings
Chest CT in a trauma patient shows a wispy, low-attenuation flap-like structure in the aorta near the diaphragm mimicking an acute traumatic intimal tear. Delayed imaging and a follow-up scan two days later showed a normal aorta without any tear, confirming a flow-related smoke artifact.
Key takeaways
Turbulent blood flow or mixing of contrast and non-contrast blood can create wispy, low-attenuation artifacts (smoke artifact) that mimic an acute traumatic aortic injury or intimal tear. Obtaining delayed-phase images or short-term follow-up scans can help differentiate artifacts from true vascular pathology.
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