A case of acute Type A Stanford aortic dissection where pulmonary artery dissection was suspected from preoperative CT findings

Abstract

 We would like to report our experience with a case of acute Type A aortic dissection where preoperative CT images led us to suspect pulmonary artery dissection. A patient was diagnosed with Stanford A acute aortic dissection based on a CT taken during an outpatient visit. The radiology department read these CT films and pointed out findings which could have been a dissection that extended from the main stem to the periphery of the pulmonary artery. On the CT, there was a delay in contrast enhancement of the pulmonary artery false lumen. Blood flow was maintained through the true lumen, and there were no apparent signs of a pulmonary infarction. In actuality, a transesophageal echocardiography and surgical findings revealed signs of a hematoma around the pulmonary artery, but there were no signs of a pulmonary artery dissection.

 Pulmonary artery dissection is an extremely rare condition. In this case, the CT findings appeared to suggest this condition, but there was no actual dissection of the pulmonary artery. Hematomas forming around the pulmonary artery can produce CT images that appear very similar to pulmonary artery dissection, so a detailed investigation is essential in order to differentiate between these two conditions.