How can you differentiate dissection from artifact on color Doppler imaging?

• A. Dissection shows distinct color flow patterns
• B. Artifact shows distinct color flow patterns
• C. Dissection shows uniform color throughout
• D. Artifact shows color edges

Answer: (A)

The key idea is that arterial dissection creates two separate flow channels separated by an intimal flap, which color Doppler can show as distinct color patterns in the true and false lumens. You may see a mobile flap and two different flow regions within the vessel, sometimes with different directions or velocities and even to-and-fro flow at the entry tear. That clear separation of flow into two luminal regions is what identifies dissection on color Doppler.

Artifact, by contrast, tends to produce spurious color along walls, edge bleeding, or uniform color without true separation into two lumens or a mobile flap. So the presence of two distinct color-flow regions separated by a visible flap is the best indicator of dissection.