A Rare Cause of Discomfort During CT Scanning

Figure 1-2

A 74-year-old female patient was brought to the emergency department due to severe back and abdominal pain. CT showed a non-A-non-B dissection, which was treated with two thoracic aortic stent grafts under occlusion of the left subclavian artery. As scheduled, the patient presented on the 4th postoperative day for postinterventional, biphasic CT. Following the examination, the patient reported feeling mild dizziness and pain in the chest area between the two scans. The ECG-triggered arterial phase (Figure 1) shows a normal ascending aorta and a normal brachiocephalic trunk (TB) measuring 13 mm, whereas venous phase images (Figure 2) show a dissection membrane (arrowhead) involving the ascending aorta; meanwhile, the TB is also dissected and has dilated to 19 mm (arrow). Thus, this Stanford type-A dissection occurred during the CT scan and resulted in emergency surgery, which confirmed the finding. This case impressively illustrates that a type-A dissection requiring immediate treatment can develop abruptly within a matter of seconds.

Dr. med. Jonas Stroeder, Florian Hasan, MD; Dr. med. Sam Mogadas, MD; Radiologie und Nuklearmedizin, Universitätsklinikum Schleswig-Holstein Campus Lübeck, [e-mail]

Conflict of interest statement: The authors declare that no conflict of interest exists.

Translated from the original German by Christine Rye.

Cite this as: Stroeder J, Hasan F, Mogadas S: A rare cause of discomfort during CT scanning. Dtsch Arztebl Int 2022; 119: 878a. DOI: 10.3238/arztebl.m2022.0301