Original MICA image-reading exercise, unscored. No clinical narrative absent from the source is added.
- Describe visible findings before proposing an interpretation.
- Suggest an interpretation and at least one image limitation.
- Which clinical findings or investigations would complement this observation?
Reveal the explained reading
Aortic dissection: intimal flap
- Sign
- Intimal flap
- Site
- Ascending aorta
- Classification
- Type A when ascending involvement is confirmed
- Priority
- Urgent aortic specialist assessment
Morphological description
A thin linear structure crosses the enhanced ascending aortic lumen at the arrow tip. The source identifies ascending aortic dissection.
Causes and diagnostic direction
Integrate acute pain, vascular examination and aortic history. Hypertension or known aortopathy may guide interpretation but cannot be inferred from the image.
Differential diagnoses
Pulsation artefact may mimic a flap. Intramural haematoma and penetrating aortic ulcer are other acute aortic syndromes with distinct criteria.
Pitfalls and limitations
Do not label true and false lumina from their apparent size on this slice alone. Absence of a complication in this field does not exclude it.
Take-home message
Identify the flap, establish ascending involvement and raise the alarm without delaying for a complete teaching exercise.
Sources
- ACC/AHA — Aortic disease guideline: key perspectives, part 2 (2022) ↗
- James Heilman, MD — document iconographique original / original image ↗
Documentary review: 2026-10-16
Media source & rights
- Author
- James Heilman, MD
- Original source
- James Heilman, MD — DissectionCT.png — CC BY-SA 3.0
- Licence
- CC BY-SA 3.0
- Changes
- Main image converted to lossless WebP, EXIF orientation applied and metadata removed. Full field, colours and annotations retained; proportional thumbnails without upscaling or clinical retouch. Original media licence retained.
- Dimensions
- 1030 × 875 px
- Check
- 2026-10-16