Welcome to another academic year!
As your new US fellows, along with the Ultrasound Division, we would like to continue the Dr. Greenstein tradition of Ultrasound of the month. Thanks to everyone for the great ultrasound images this past month - it was truly a challenge to pick the single best image of the month.
The Ultrasound of the month winner for July is Dr. Kaitlin Parks. Please see the fellows for your prize!
Dr. Parks had a great pick up of a type B aortic dissection on a patient with ESRD, HTN and a known pericardial effusion who presented with chest pain after a missed dialysis session. Dr. Parks very appropriately performed a cardiac ultrasound. After imaging the IVC, she noted an irregularity in the descending aorta, consistent with a dissection flap, prompting her to order a dissection protocol CT. The CT confirmed the presence of a type B dissection originating at the distal margin of the left subclavian artery, terminating just superior to the origin of the SMA. The patient was admitted to the ICU and was medically managed.
The ultrasound clip below clearly demonstrates a mobile dissection flap within the lumen of the aorta. The image appears to show the dissection flap terminating at the origin of the SMA (as read on the CT scan).
CT scan image showing the type B dissection - note that the celiac trunk is supplied by the false lumen!
Keep up the great work!
Your Ultrasound Fellows,
Ian and Alek