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Updated: Oct 24, 2026

An Approach to Point-Of-Care Ultrasound Evaluation of the Abdominal Aorta
07:12

An Approach to Point-Of-Care Ultrasound Evaluation of the Abdominal Aorta

Published on: September 8, 2023

Transesophageal echocardiographic Doppler findings in patients with penetrating aortic ulcers

S Atar1, T Nagai, Y Birnbaum

  • 1Cardiac Non-Invasive Laboratory, Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.

The American Journal of Cardiology
|March 12, 1999
PubMed

Insights

Transesophageal echocardiography may not distinguish penetrating aortic ulcers from intramural hematomas. Color and pulsed-wave Doppler flow offer a potential method for identifying penetrating aortic ulcers.

Area of Science:

  • Cardiovascular imaging
  • Vascular diagnostics

Background:

  • Penetrating aortic ulcers (PAU) and intramural hematomas (IMH) are acute aortic syndromes.
  • Differentiating PAU from IMH is crucial for appropriate clinical management.
  • Transesophageal echocardiography (TEE) is a common imaging modality, but differentiation can be challenging.

Purpose of the Study:

  • To evaluate the utility of Doppler flow patterns in differentiating penetrating aortic ulcers from intramural hematomas.
  • To determine if specific Doppler characteristics can reliably identify PAU.

Main Methods:

  • Retrospective analysis of TEE findings in patients with confirmed PAU and IMH.
  • Assessment of color Doppler and pulsed-wave Doppler flow patterns within the aortic wall and lumen.
  • Correlation of Doppler findings with computed tomography angiography (CTA) or surgical data.

Main Results:

  • TEE alone had limitations in definitively distinguishing PAU from IMH in some cases.
  • Specific color and pulsed-wave Doppler flow patterns were observed in PAU, indicative of blood flow into the aortic wall.
  • These Doppler findings demonstrated higher sensitivity and specificity for PAU detection compared to grayscale TEE imaging alone.

Conclusions:

  • Doppler flow assessment, using both color and pulsed-wave modalities, can significantly improve the accuracy of differentiating penetrating aortic ulcers from intramural hematomas.
  • This technique offers a valuable adjunct to standard TEE for diagnosing PAU.

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