[Evaluation of aortic dissection by transverse computerized tomography (CT scan)].

Twenty patients with dissection of the thoracic aorta were studied by CT-scanning. In 9 patients the diagnosis was previously documented by aortography, while in the other 11 patients the diagnosis of aortic dissection was first established by CT-scanning. The latter demonstrated the characteristic signs of aortic dissection and particularly the following features: a) the false channel (95%) and the intimal flap (90%), b) the displacement of aortic wall calcifications (60%), especially when the false channel is partially thrombosed (80%). In 19 patients, a bolus injection of contrast medium was performed. In the majority of cases opacification of the false channel occurred only partially, with some delay and with a non-homogeneous pattern. Six out of the 20 patients underwent one or more follow-up examinations performed between 15 days and 2 years later. CT-scanning clearly demonstrated the late persistence of a patent false channel and particularly the delayed thrombosis, even after surgical treatment of aortic dissection. CT-scanning appears to be a reliable non-invasive method for - establishing the diagnosis of aortic dissection, - delineating the extent of dissection, - follow-up of evolution after surgical or medical therapy.