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Acute aortic syndromes: pathology and imaging

¹ Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands, ² Department of Radiology, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK, ³ Department of Medical Imaging, University of Liverpool, UK and ⁴ Department of Radiology, The Cardiothoracic Centre, Liverpool, UK

Correspondence: Dr Richard McWilliams

• Consist of three interrelated pathologies; intramural haematoma, penetrating atherosclerotic ulcer and aortic dissection.
  
• Multislice CT is the modality of choice.
  
• A pre-contrast scan is essential to detect intramural haematoma.
  
• Intramural haematoma needs repeated imaging follow up and can progress to penetrating atherosclerotic ulcer (PAU), psuedoaneurysm or dissection.
  
• In aortic dissection the false lumen is usually larger and may contain aortic "cobwebs".
  

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