ddxof: CT Interpretation Series

CTA AORTA
CT PE
PULMONARY ANGIOGRAPHY

Vascular Window Vascular Window

Axial Plane Axial and Oblique Planes

CIRCULATION 1 CIRCULATION

Look For: Look For:

• Aortic syndromes • Filling defects
- Dissection • Commonly occur at branch
- Intramural Hematoma points
- Penetrating atherosclerotic Normal Dissection
ulcer Assess Quality:
• Central PE • PA > Ao
• PA > 20HU
Assess Quality: • Contrast extends to
• Ao > PA subsegmental level
Hematoma Ulcer

DISSECTION

Evaluate:
• Origin and extent: Stanford
classification
A: Ascending Aorta
B: Beyond Brachiocephalic
• True lumen: smaller, more dense,
Oblique plane aids with
originates at aortic root
• Complications: hematoma, active visualization
extravasation

COMPLICATIONS

Look For:
• PA root dilation >3cm
• Compare to prior imaging if
available (chronic dilation
suggests pulmonary
hypertension)

INTRAMURAL HEMATOMA
Look For:
• RV > LV
Look For: • Septal flattening/bowing
• Crescent-shaped, low-attenuation • Contrast reflux into hepatic
relative to post-contrast aorta veins
• Precursor to aortic dissection
Note:
Aortic Root Dilation: These findings correlate with
POCUS evaluation (RV dilation, D-
• Ectasia: 3.5-4.0cm sign, dilated IVC)
• Aneurysm: >4cm
• Rupture risk: >5cm

PENETRATING Lung Window

ATHEROSCLEROTIC ULCER Axial Plane

Look For: 2 AIRWAY

• Contrast-filled outpouching
• May progress to perforation or
dissection
Look For:
Management: • Patency of trachea and bronchi

Shared across aortic syndromes,

impulse control and surgical
evaluation

BREATHING 3

Pleura:
• Pleural Line
• Pleural Potential Space
- Pneumothorax
- Pleural fluid
- ○ <20 HU simple fluid
○ >20 HU complex
○ >Hct HU blood

Parenchyma: Parenchyma:

MEDIASTINUM 4 • Atelectasis
• - Enhancing (densely
• Consolidation
• - Non-enhancing (vascular
vascularized, not aerated) shunting)
- Volume loss, tightly-packed - Normal architecture
SOFT-TISSUE 5 vessels and bronchioles

BONE 6

VISUALIZED UPPER ABDOMEN 7