Dissektion Pulmonalarterien

Akute

Dissektion der Pulmonalarterie: Abbildung 3: Kontrastmittelverstärkte Computertomographie-Pulmonalisangiographie: axiale dünne «maximum intensity projection» (MIP) mit Darstellung der massiven Dilatation des Truncus pulmonalis und der Pulmonalarterien sowie der Dissektionsmembran.

smf.swisshealthweb.ch • CC BY-NC-ND 4.0

Idiopathic

pulmonary artery dissection: a case report. Computed tomography of the chest with contrast showing a linear hypodensity within the main pulmonary artery suggestive of an intimal dissection flap of the trunk of the main pulmonary artery without dilation.

jmedicalcasereports.biomedcentral.com • CC-by-2.0

Idiopathic

pulmonary artery dissection: a case report. Cardiac magnetic resonance imaging demonstrating an intimal dissection flap of the main pulmonary artery.

jmedicalcasereports.biomedcentral.com • CC-by-2.0

A case of

giant main pulmonary artery aneurysm associated with complicated congenital heart disease and simultaneous chronic pulmonary artery dissection. Computed tomography angiography. a Main pulmonary aneurysmal dilation with a diameter of 14 cm. b Aortic coarctation at the aortic isthmus and a small patent ductus arteriosus at the ductus arteriosus. c CTA showing pulmonary artery dissection

cardiothoracicsurgery.biomedcentral.com • CC-by-4.0

Akute

Dissektion der Pulmonalarterie: Abbildung 5: Kontrastmittelverstärkte Computertomographie-Pulmonalisangiographie: koronare dünne «maximum intensity projection» (MIP) mit Darstellung der Kompression des kaliberkräftigen mittleren RIVA (Pfeil) durch das Aneurysma und Dissektion des Truncus pulmonalis.

smf.swisshealthweb.ch • CC BY-NC-ND 4.0

Radiopaedia • CC-by-nc-sa 3.0 • de

Pulmonary arterial dissection is extremely rare but can be a fatal situation. Only a handful of cases have been described in live patients.

Pathology

It is mostly described in those with chronic pulmonary arterial hypertension.

It can progress to a pulmonary artery aneurysm and fatal spontaneous rupture into the pericardium causing acute cardiac tamponade.

Location

It is usually seen involving the main pulmonary trunk, which is the affected site in 80% (usually without involvement of its branches) .

Clinical presentation

The condition usually manifests with cardiogenic shock sudden death .

Radiographic features

CT, MRA and echocardiography will demonstrate the intimal flap. Gated CT scans can be useful in assessment.

Differential diagnosis

A potential pitfall is a pseudoflap due to motion artifact from aortic and cardiac motion. The presence of a similar pseudoflap in the aorta or superior vena cava would suggest that the finding is an artifact.