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Subjective: To assess the VIE value in displaying three-dimensional endovascular structures of AD.Methods Among 127 consecutive symptomatic subjects with suspected AD who underwent CT angiography(CTA),84 patients with AD were included in the study.Conventional CT and the VIE images were observed and evaluated.Results On the basis of 92 entry tears revealed on conventional CT,88(95.7%)tears were shown on VIE with round(n=26),slitlike(n=9)or irregular(n=53)shapes,and the entire intimal flap was sheetlike(n=34),tubular(n=34),wavelike(n=13)or irregular(n=7)in shape.The VIE also showed the spatial relationship of torn flap and adjacent structures.Among 58 entry tears with multiple-line type flap on conventional CT,41(70.7%)were irregular in shape on VIE,whereas among other 30 tears with singleline type flap,17(56.7%)were round or slit-shaped on VIE; which demonstrated a significant difference(P <0.05).Worse display of tears on VIE was related to lower CT attenuation values in lumen or neighboring artifacts(P <0.01).Conclusions CT VIE shows entire configurations and details of intimal tear and flap of AD more than conventional CT approaches,and it should be recommended as a necessary assessment tool for endovascular therapy and strategy planning in pre-surgical patients.