It is generally large and has slow swirling spontaneous echo contrast. This is due to poor run off from the false lumen. Again morphology and mobility features of the intimal flap as described above are used to identify the false lumen. Often some degree of thrombus is seen in the false lumen. Doppler flow features at the entry site can also identify the true and false lumen. Recognition of the false lumen becomes very important in the arch as well as in the abdominal aorta because of blood supply to the branches. This has enormous impact on surgical management and the need for subsequent percutaneous intervention. An ultrasound contrast agent can be used to help identify the true and false lumen. Contrast washout time is delayed in the false lumen.
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