{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:18:47Z","timestamp":1760059127493,"version":"build-2065373602"},"reference-count":42,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Shin Kong Wu Ho-Su Memorial Hospital","award":["2020SKHADR018","2021SKHADR014"],"award-info":[{"award-number":["2020SKHADR018","2021SKHADR014"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Common carotid artery dissection (CCAD) can result in severe neurological sequelae; however, its diagnosis may be challenging due to consciousness disturbance and aphasia. The objective of this article is to propose a new imaging feature to assist in the identification of CCAD. Methods: This retrospective case series enrolled 139 patients with discharge diagnoses of aortic dissection who underwent carotid ultrasound during admission over a period of three years. Results: Among these patients, 23 had type A aortic dissection, and 113 had type B aortic dissection or related conditions. Notably, among the 23 patients with type A aortic dissection, eight had associated common carotid artery dissection (CCAD), and a total of nine CCAD events were identified. Meanwhile, a B-mode ultrasound revealed six double lumens with intimal flaps and three intramural thrombi. The \u2018train-line\u2019 pattern in ultrasonography was discerned by detecting a hypoechoic thickened wall, which was characterized by a margin formed by two parallel linear reflections in close proximity. This distinctive \u201ctrain-line\u201d pattern was identified in three intimal flaps and two intramural thrombi. Conclusions: While double lumens and intramural thrombus are prevalent findings, the latter may be misinterpreted as atherosclerotic plaque. The \u201ctrain-line\u201d pattern may aid in distinguishing intramural thrombus from atheromatous plaque, offering an additional diagnostic tool alongside the identification of double lumens with intimal flaps.<\/jats:p>","DOI":"10.3390\/diagnostics15101297","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T13:59:43Z","timestamp":1747835983000},"page":"1297","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Train-Line Pattern on Duplex Ultrasound Helps Differentiate Intramural Thrombus from Atheromatous Plaque in Common Carotid Artery Dissection"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2009-6057","authenticated-orcid":false,"given":"Ming-Hsing","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111045, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yen-Yu","family":"Huang","sequence":"additional","affiliation":[{"name":"Chen Sen-Feng United Clinic, Taipei 114002, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang-I","family":"Hsieh","sequence":"additional","affiliation":[{"name":"School of Public Health, College of Public Health, Taipei Medical University, Taipei 110301, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0559-3514","authenticated-orcid":false,"given":"Kuan-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111045, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsu-Ling","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111045, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai-Jing","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111045, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6533-2650","authenticated-orcid":false,"given":"Li-Ming","family":"Lien","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111045, Taiwan"},{"name":"College of Medicine, Taipei Medical University, Taipei 110301, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/14017431.2019.1660401","article-title":"Acute type A aortic dissection\u2014A review","volume":"54","author":"Gudbjartsson","year":"2020","journal-title":"Scand. 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