Superior pericardial recess simulating aortic dissection on computed tomography

Computed tomography is frequently used in the initial workup of patients with suspected aortic dissection to distinguish dissection involving the ascending aorta from dissection limited to the descending aorta. We reviewed CT of 19 patients who were proven by aortography to have normal ascending aortas. In eight patients the superior extension of the pericardium was visualized and thought to be a potential source of a false-positive diagnosis of type A aortic dissection.