Radiologic findings of dissecting aneurysm of the aorta

In a series of eight cases of dissecting aneruysm of the aorta, the diagnosis is suggsted on the basis of the clinical picture. plain chest roentgenogram and aortography. Eight cases of plain chest film and six aortogramsare available and analysis of them discloses that; 1. Male to female ratio is 3:1. Their age ranges from 38 to 64 years with an average of 55 years. 2. All of them except one suffer from hypertension. The most consistent clinical symptoms are severe pain and dyspnea. Weak femoral pulse is noted in only one patient. There is nocorrelation between the clinical picture and the type of the aneruysm. Three patients were discharged with symptomatic improvement and five, expired. Surgery was performed in two cases. 3. Conventional radiographs of thechest show suggestive signs including widening of the mediastinum and the aorta with shift of trachea to the rightside, obliteration of the aortic knob, and left pleural effusion. The deminished pulsation on lesion ordisplacement of intimal calcification is noted in one case, respectively. 4. Aortography was carried out in sixpatients. De Bakey's type I is three cases. II one case, and III four cases. Diagnostic criteria are duble lumenof the aorta, narrowing of the true lumen, abnormally thick aortic wall and branch involvement. Two cases of aortic insufficiency are also present. 5. Even with clinical finding ane chest P-A dissecting anerysm is highly suspected, aortography is necessary for the definitive diagnosis and the determination of prognosis for adequate greatment.