Multi-detector computed tomography in the diagnosis and management of acute aortic syndromes

Figure 10 A 62-year-old with acute chest pain. A computed tomography aortogram (A-coronal) shows a penetrating atherosclerotic ulcer at the proximal descending aorta with contrast seen within the aortic media (black arrows) and non-opacifying hyperdensity throughout the rest of the descending thoracic aortic wall compatible with intramural haematoma (white arrow). The axial image (B) shows the contrast extending within the aortic wall and splitting the same. The sagittal oblique reconstruction (C) gives a better demonstration of the penetrating atherosclerotic ulcer at the distal aortic arch (black arrow) with intramural hematoma and progressing into an aortic dissection (white arrow).