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DISSECTION

A type B dissection is distal to the aortic arch. The flap may extend into the abdominal aorta. A dissection flap is hyperechoic, undulating and has independent movement to the aortic pulsations. When imaging the abdominal aorta, other structures may look like dissection flaps due to slice thickness or reverberation artefacts. Therefore always image in 2 planes. If in doubt image the aorta from an alternative window eg LUQ/ RUQ. 

Dissection flap in the abdominal aorta: note the independent movement of the caudal end

Abdominal Aorta long: difficult to visualise dissection flap (arrow)

Same patient as above, Aorta visualised from the RUQ: dissection flap seen clearly.

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