CTICasesType A Aortic Dissection with Large Intramural Hematoma
Imaging findings
Non-contrast CT shows a dilated ascending aorta with a small pericardial effusion. Contrast-enhanced CT reveals a large type A aortic dissection with an intima-medial flap originating at the sinotubular junction and a large, non-contrast-containing intramural hematoma extending proximally into the aortic root, specifically involving and bulging near the non-coronary sinus, compressing the left atrial appendage.
Key takeaways
Type A aortic syndromes can present with complex anatomy, including an intimal tear at the sinotubular junction combined with a large retrograde intramural hematoma extending into the aortic root and non-coronary sinus. Surgical findings in this case confirmed inflammatory pericardial reaction and hematoma in the aortic wall.
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