Figure 1:

Serial chest CT images in a 68-year-old female patient (patient 1). (A) Axial chest CT image at the level of the aortic root. The nongated chest CT examination was performed to rule out pulmonary embolism before the actual hospitalization. The arrow indicates a normal aortic wall. Two weeks later, the patient underwent invasive coronary angiography for recanalization of the circumflex artery. After the first contrast media injection in the aortic root, extravasation of contrast media into the aortic wall was noticed (image not shown). CT performed 30 minutes after invasive coronary angiography demonstrated a crescent-shaped hyperattenuation, reflecting undiluted contrast media in the aortic wall (Dunning type III; arrow on B, an electrocardiographically [ECG]–gated nonenhanced chest CT image and C, an ECG-gated contrast-enhanced chest CT image). Follow-up CT the following day showed complete resolution of the contrast media accumulation (arrow in D).