Intimal Flap and Beak Sign

Abstract

Detection of an “intimal flap” (better intimomedial flap) must be considered as the most reliable sign of aortic dissection which represents a linear filling defect after IV enhancement (∆). This flap separates true and false channels of the aorta. The sharp marginal angle between the aortic wall and the intimal flap so as its crescent form – “beak” sign – usually indicates the channel with lower intraluminal pressure (↑). These changes in the aorta can coexist with the “cobweb” sign. On native images, the “beak” sign becomes apparent when calcified intima moves inside (►►).

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Detection of an “intimal flap” (better intimomedial flap) must be considered as the most reliable sign of aortic dissection which represents a linear filling defect after IV enhancement (∆). This flap separates true and false channels of the aorta. The sharp marginal angle between the aortic wall and the intimal flap so as its crescent form – “beak” sign – usually indicates the channel with lower intraluminal pressure (↑). These changes in the aorta can coexist with the “cobweb” sign. On native images, the “beak” sign becomes apparent when calcified intima moves inside (►►).