Abstract

Objective: To describe the imaging characteristics of thoracic aortic dissection on multidetector computed tomography.

Methods: A cross-sectional descriptive study was carried out on 37 patients diagnosed with thoracic aortic dissection at the Department of Radiology, Hue Central Hospital, from April 2023 to April 2025.

Results: Among the 37 patients, males accounted for 64.9%, with a mean age of 56.41 ± 12.74 years; the majority of dissections occurred in the 50-59-year age group (24.3%). Two patients could not be classified by the Stanford system and were categorized as non-A non-B type according to the TEM classification. The most common computed tomography (CT) findings were the beak sign (97.3%), cowbweb sign (73%), false lumen diameter greater than the true lumen (73%), calcification of the true lumen wall (73%), and displaced intimal calcification (73%).

Conclusion: In this study, 54.1% of patients were diagnosed with type A AAD, 40.5% with type B, and 5.4% with non-A non-B. Almost patients had at least one intimal tear. The beak sign proved to be the most reliable indicator for distinguishing the true from the false lumen, while a flat and thickened intimal flap was useful in differentiating acute from subacute–chronic dissections. Patients with type A AD have a larger maximum aortic diameter and ascending aortic diameter compared to those with type B, but smaller values for the descending aortic diameter. The renal artery was the most frequently affected vessel (59.5%), although only 13.5% presented with clinical or imaging evidence of ischemia. The TEM classification provided additional information on tear location and organ malperfusion, thereby clarifying disease progression and enabling early prediction of in-hospital mortality.