CTICasesAortic Pseudo-Dissection Artifact from Pneumomediastinum and Cardiac Pulsation
Imaging findings
An initial trauma CT scan showed an apparent abnormality of the descending aorta, specifically an apparent dissection confined to an anterior portion, atypical in location, appearance, and length for an acute injury. There was also extensive mediastinal emphysema and pneumomediastinum. A subsequent ECG-triggered CT scan showed no aortic abnormality, confirming the initial finding was artifactual.
Key takeaways
Mediastinal emphysema combined with streak artifact and cardiac pulsation (especially in tachycardic patients) can create pseudo-dissection artifacts in the aorta on CT, particularly in trauma settings. Careful assessment in multiple planes and a high index of suspicion for artifact, followed by ECG-triggered repeat imaging, can prevent unnecessary intervention.
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