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[Aortic intramural hematoma: aspects with spiral computerized tomography].

M Midiri1, A Strada, A A Stabile Ianora

  • 1Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Diagnostica per Immagini, Università degli Studi, Bari.

La Radiologia Medica
|January 10, 2001
PubMed
Summary

Helical CT effectively identifies aortic intramural hematoma, distinguishing it from dissection. This imaging technique is crucial for early diagnosis and management of this aortic condition.

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Area of Science:

  • Cardiovascular Imaging
  • Diagnostic Radiology
  • Vascular Surgery

Background:

  • Aortic intramural hematoma is a distinct pathological entity.
  • It requires differentiation from aortic dissection for appropriate management.
  • Advanced imaging plays a critical role in its diagnosis.

Purpose of the Study:

  • To evaluate the imaging signs of aortic intramural hematoma using helical CT.
  • To determine the diagnostic accuracy of helical CT for this condition.

Main Methods:

  • Retrospective review of 396 patients with suspected aortic dissection.
  • Analysis of helical CT findings in 18 patients diagnosed with aortic intramural hematoma.
  • Dynamic contrast-enhanced CT parameters and specific imaging features were assessed.

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Main Results:

  • Aortic wall thickening (eccentric or concentric, >4 mm) was a consistent finding.
  • High density on baseline CT and low density on enhanced images characterized the hematoma.
  • Associated findings included intimal calcifications and hemomediastinum/hemothorax.

Conclusions:

  • Helical CT is accurate in identifying aortic intramural hematoma localization and extension.
  • It is a valuable tool for early diagnosis, differentiating it from aortic dissection.
  • Timely diagnosis aids in guiding treatment and preventing complications.