Case 181

 A sixty six-year-old male presented in our hospital for thoracic pain, back pain and palpitation. He sometimes experienced thoracic pain at the time of physical working from three years before. In these days, he got thoracic pain more strongly not only during physical working but at the time of waking up or going to bed. Last night, he felt thoracic pain more strongly than ever.
 Blood pressure 183/97 mmHg, pulse 66/min. EKG showed ST elevation on V1 and V2. Laboratory test revealed CRP 0.26 mg/dL, white blood cells 9590/mm³, BNP 50.5 pg/mL (<18.4), toroponin I 115 pg/mL (< 140). He took thoracic CT for further investigation (Figs. 1, 2).

What is the space indicated by arrow
on thoracic CT figures ?

1.　Aortic dissection space

2.　Aortic atheroma ulcer

3.　Bronchogenic cyst

4.　Pericardial recess

5.　Mediastinal lymph-node

answer

2020.2.19