Do we really need a true non-contrast scan for aortic imaging?
67 yo M presents with chest pain. Prior history of CABG.
A routine CT angiogram of the aorta was performed. A Stanford type A dissection is seen, with a partially thrombosed false lumen. Turn on spectral, and the thrombosed false lumen is seen as a high density crescent about the ascending aorta on the virtual non-contrast.
Lower down in the abdominal aorta, we see plaque at the level of the inferior mesenteric artery, confirmed by low density on virtual non-contrast.
The ascending aortic dissection was surgically repaired.
We do not do a true non-contrast acquisition for imaging the aorta. It does not add anything but radiation.