Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Case 39 Aortic pulsation artifact
- Case 40 Mediastinal widening due to non-hemorrhagic causes
- Case 41 Aortic injury with normal mediastinal width
- Case 42 Retrocrural periaortic hematoma
- Case 43 Mimicks of hemopericardium on FAST
- Case 44 Mimicks of acute thoracic aortic syndromes: aortic dissection, intramural hematoma, and penetrating aortic ulcer
- Case 45 Aortic intramural hematoma
- Case 46 Pitfalls in peripheral CT angiography
- Case 47 Breathing artifact simulating pulmonary embolism
- Case 48 Acute versus chronic pulmonary thromboembolism
- Case 49 Vascular embolization of foreign body
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Case 45 - Aortic intramural hematoma
from Section 4 - Cardiovascular
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Case 39 Aortic pulsation artifact
- Case 40 Mediastinal widening due to non-hemorrhagic causes
- Case 41 Aortic injury with normal mediastinal width
- Case 42 Retrocrural periaortic hematoma
- Case 43 Mimicks of hemopericardium on FAST
- Case 44 Mimicks of acute thoracic aortic syndromes: aortic dissection, intramural hematoma, and penetrating aortic ulcer
- Case 45 Aortic intramural hematoma
- Case 46 Pitfalls in peripheral CT angiography
- Case 47 Breathing artifact simulating pulmonary embolism
- Case 48 Acute versus chronic pulmonary thromboembolism
- Case 49 Vascular embolization of foreign body
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Summary
Imaging description
Aortic intramural hematoma (IMH) results from rupture of the vasa vasorum and hemorrhage into the arterial media, which leads to weakening of the aortic wall, but absence of the intimal disruption that characterizes an aortic dissection [1]. Intramural hematoma of the thoracic aorta can be classified with the Stanford system similar to aortic dissections, with a Stanford type A involving the ascending aorta, and a Stanford type B involving the descending aorta.
Intramural hematoma can be diagnosed with echocardiography, CT, and MRI. Transesophageal echocardiography has been reported to have a sensitivity of up to 100% and specificity of 91%, and transthoracic echocardiography has a reported sensitivity range of 77–80%, although both of these modalities are operator dependent. CT and MR also have a sensitivity and negative predictive value which approach 100% [1, 2], but because it is less time-consuming and typically more readily available than MR, CT has become the diagnostic test of choice in suspected acute aortic syndrome (AAS).
- Type
- Chapter
- Information
- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 151 - 152Publisher: Cambridge University PressPrint publication year: 2013