Tennis ball sign: a CT sign of acute aortic dissection

Excerpt

Aortic dissection is a clinical emergency in which there is separation of the layers (tunica intima and tunica media) of aortic wall with accumulation of blood within. It requires an early and accurate diagnosis as the untreated condition can be rapidly fatal. With the advent of multidetector computed tomography (CT), more cases are being diagnosed on CT angiography when the patients present with severe chest or abdominal pain of sudden onset [1]. CT angiography has an accuracy of up to 100% in the diagnosis of acute aortic dissection [2]. The normal CT angiographic appearance of the aorta shows uniform contrast opacification of the lumen. In case of dissection of the aorta, the intimal flap raised by the ingress of blood creates a false lumen (or a double barrel lumen) on axial CT images, sometimes mimicking the appearance of a tennis ball (Figs. 1, 2)—an observation initially made by Patruno et al. [3].

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