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Objective: To use the time-density curves (TDCs) to quantitatively distinguish the true from false lumen of aortic dissection (AD)., Methods: 28 cases with AD underwent the dynamic scanning of 16-slice spiral computer tomography (SCT). We used the CT Dynamic Evaluation software to determine the circulation times of the true and false lumens of the AD and got the TDCs, and then analyzed the circulation times and CT values of the true and false lumens by using matched t-test for dependent samples., Results: The TDCs of the true and false lumens of the AD were achieved in all 28 patients. The peak CT values [(71.87 +/- 35.14) HU] of the true lumen were higher than those [(45.58 +/- 24.00) HU] of false lumen (P < 0.05); while the time to peak [(23.43 +/- 5.73) s] of the true lumen were earlier than that [(29.46 +/- 6.27) s] of false lumen (P < 0.05). The patterns of TDCs of the true lumen appeared to be rapid rise followed by rapid decline in 22 cases (78.6%) and rapid rise with gradual decline in 6 (21.4%), while the patterns of TDCs of the false lumen showed gradual rise followed by gradual decline in 18 cases (64.3%) and rapid rise with gradual decline in 10 (35.7%)., Conclusion: The TDCs of the true and false lumens showed: the peak CT values of the true lumen were higher than those of false lumen; while the time to peak of the true lumen were earlier than that of false lumen. So, the time-density curve, is used as an original and quantitative method to distinguish the true from false lumen in AD.

Objective: To determine the CT features and anatomic-pathologic basis of the 16-slice Spiral CT (SCT) for aortic dissection (AD)., Methods: Forty-two cases with typical aortic dissection (AD) and 12 cases with intramural hematoma (IMH) underwent 16-slice SCT, performed with unenhanced, contrast-enhanced scanning and three-dimensional reconstruction. More attention was put on the true and false lumen, intimal flap, the entry tear and the involvement of branches of AD., Results: (1) True and false lumen and intimal flap of AD could be shown in all of 42 cases (100%), the entry tears were revealed in 41 cases (97.6%), and the true and false lumen and intimal flap extended spirally in 41 cases (97.6%). (2) For intramural hematoma (IMH), unenhanced CT depicted crescent-shaped areas with high attenuation extending along the walls of the aorta in 10 cases (83.3%), and low attenuation in 2 cases (16.7%), while contrast-enhanced CT showed no enhancement of attenuation in the crescent-shaped areas in all 12 cases. Nine cases (75%) of IMH were associated with penetrating aortic ulcer., Conclusions: The axial and three-dimensional images of 16-slice SCT can fast and exactly reveal the pathological and anatomical features of AD, and provide detailed imaging information for clinical therapy. It's very important for the selection of treatment methods.

Abstract: Interrupted aortic arch (IAA) is a rare congenital cardiovascular condition. A patient with uncorrected IAA accompanied by rich collateral arteries can survive to adulthood asymptomatically. However, IAA complicated by aortic dissection is life threatening. Herein, we report a rare case of an isolated IAA accompanied by type B aortic dissection and extensive collateral arteries detected by multidetector computed tomography in a 38-year-old man. The imaging findings of the case are presented, and the utility of multidetector computed tomography in the evaluation of this condition is discussed. [Copyright &y& Elsevier]