Acute aortic syndromes include three life-threatening pathologies: acute aortic dissection, intramural hematoma and penetrating aortic ulcer. The incidence of aortic dissection is around 5-30 cases per 1 million people per year, with a mortality rate as high as 30%.

25 patients who presented to the ER with complaints about acute dissection were taken for CT angiography for diagnosis, on a 128 slice machine, 5 mm axial reconstructions and coronal, sagittal and oblique MPRs were done.

A non-enhanced scan of the thoracic aorta is included for the detection of an intramural hematoma. This is followed by a contrast-enhanced scan of the aorta in the arterial phase with bolus triggering and in the venous phase. Contrast differences between arterial and venous phases can be helpful in differentiating true and false lumen. The iliac tract is included for the evaluation of endovascular treatment possibilities. 

Involvement of ascending aorta is classified as Stanford type A and has rapid lethal complications requiring surgery, while lesions not involving ascending aorta are grouped as Stanford type B, having a lesser rate of complications.

During the acute to longitudinal progression, various specific and nonspecific imaging findings are encountered, including pleural and pericardial effusions, fluid collections, progression including aortic enlargement, and postoperative changes that can be discerned at CT. 

DeBakey classification of aortic dissection is of three types: type I = ascending arch and descending aorta, type II = only ascending aorta, and type III = only descending aorta.

 The Stanford classification is most widely used owing to its simplicity in aiding split-second decision-making in the acute phase of dissection.