Atypical presentation of dissection of the ascending aorta in young men with cystic medial necrosis: MR findings.

Dissection of the ascending aorta is usually associated with severe chest and/or back pain. We describe three young men, with pathologically proven cystic medial necrosis, who presented with atypical clinical symptoms and ascending aortic dissection diagnosed by MR imaging and surgery. Patients with cystic medial necrosis and aortic dissection may not present with a classic acute chest pain syndrome.