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Marfan Syndrome and Stanford Type B Aortic Dissection: CT Angiography, MRI Findings, Treatment Decisions, and Long-Term Surveillance

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  A Case-Based Radiology Review of Acute Chest and Abdominal Pain in a Young Woman Edited by Dr. SB Lee Executive Answer Stanford type B aortic dissection should be considered urgently when a patient with Marfan syndrome develops sudden chest or abdominal pain. In this case, CT showed an aortic dissection beginning just distal to the origin of the left subclavian artery, near the aortic isthmus, involving the proximal descending thoracic aorta and the origin of an aberrant right subclavian artery. The initial study identified no contrast extravasation. Follow-up CT one week later showed no significant interval change. MRI additionally demonstrated lumbosacral dural ectasia and posterior vertebral scalloping, supporting the multisystem imaging phenotype of Marfan syndrome. The central clinical lesson is that short-term imaging stability does not eliminate long-term aortic risk. Why This Case Matters Aortic dissection is a time-sensitive vascular emergency, but its presentation does ...
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Takayasu Arteritis on Neck CTA: A 30s Woman With Dizziness, Carotid Stenosis, and Subclavian Artery Occlusion

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  Edited by ScholarGen MediAI Team Executive Answer Takayasu arteritis should be considered when a young patient presents with otherwise unexplained systemic symptoms and dizziness together with multifocal large-vessel abnormalities. In this case, neck CT angiography (CTA) demonstrated bilateral subclavian artery origin occlusion, severe proximal right common carotid artery stenosis, diffuse narrowing of the right internal carotid artery, and approximately 75% stenosis of the left common carotid artery. Concentric arterial wall thickening and collateral reconstitution further support a large-vessel vasculitic process. The key radiologic lesson is that Takayasu arteritis is not simply a stenosis diagnosis: the radiologist must interpret the arterial wall, lesion distribution, occlusion, distal reconstitution, collateral circulation, and potential complications as one vascular system. Why This Case Matters Dizziness is common and has a broad differential diagnosis. Inner-ear disorder...
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Pediatric Ménétrier Disease: CT and Endoscopic Findings of Giant Gastric Folds in a 5-Year-Old Boy

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  Edited by ScholarGen MediAI Team Executive Answer Ménétrier disease is a rare protein-losing gastropathy characterized by markedly enlarged gastric rugal folds, typically involving the gastric body and fundus, with associated hypoalbuminemia and edema. In this 5-year-old boy, the combination of nausea, vomiting, intermittent abdominal pain, mild periorbital edema, severe hypoalbuminemia, and giant cerebriform gastric folds on contrast-enhanced CT and endoscopy strongly supports pediatric Ménétrier disease. Gastric biopsy demonstrated foveolar hyperplasia with glandular atrophy, while testing for Helicobacter pylori and viral inclusions was negative. Technetium-99m-labeled human serum albumin scintigraphy demonstrated gastrointestinal protein loss. The child improved with supportive treatment, with symptoms resolving four months after presentation. Why This Case Matters Pediatric Ménétrier disease is uncommon and can initially resemble a much more routine gastrointestinal illness...
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