Findings:
There is an aortic dissection with the intimal flap originating within the proximal descending thoracic aorta and terminating near the aortic bifurcation. The intimal flap is fenestrated proximally and distally. There is a false lumen that opacifies less than the true lumen. The true lumen supplies the celiac artery, SMA, left renal artery, and IMA. The mid-descending aorta measures 5.8x6.0cm. The lower descending aorta measures 5.7x6.1. The ascending aorta and arch are non-aneurysmal and without dissection. There is severe narrowing of the proximal celiac artery. The right renal artery is supplied by the false lumen but is patent. There is mild aortic and iliofemoral atherosclerosis. In the lungs, there is emphysema with scattered groundglass opacities. There are scattered predominantly centrilobular nodules. There are large bilateral benign type Bosniak I simple renal cysts.

Impression:
There is a Stanford type B thoracoabdominal aortic dissection with a fusiform thoracoabdominal aortic aneurysm. The right renal artery is supplied by the false lumen and the right kidney is hypoenhancing compared to the left. There is also segmental narrowing of the proximal celiac artery. There are several small lung nodules for which follow-up CT is recommended.

Recommendations:
For your training purposes, recommendations are not included in this report.