CTICasesAortic Pseudo-Dissection (False Aortic Contour) from Pleural Effusion
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Imaging findings
A chest radiograph shows a new, large pleural effusion and a change in the aortic contour at the arch level, with apparent separation. CT, however, reveals no aortic dissection. Instead, a pleural effusion wraps around the aorta, displacing the lung medially, creating a 'Wasser sichel' (water crescent) effect that mimics an aortic abnormality.
Key takeaways
This is a great case demonstrating a radiographic pitfall. A large pleural effusion can mimic an aortic dissection by creating a false contour of the aorta, a phenomenon termed 'aortic pseudo-dissection' or 'Wasser sichel.' CT is crucial for differentiating this benign appearance from true aortic pathology.
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