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Published on: July 16, 2018
"Hyperdense" aortic wall: potential pitfall in CT screening for aortic dissection
1Department of Radiology, University of Texas Southwestern Medical Center, Dallas 75235.
Insights
Aortic wall hyperdensity on CT scans is not a reliable indicator of anemia. While it can suggest anemia in younger patients, atherosclerosis is the more common cause in nonanemic individuals.
Area of Science:
- Radiology
- Cardiovascular Imaging
- Diagnostic Imaging
Background:
- Aortic wall opacity on CT scans has been used to diagnose aortic dissection and has been linked to severe anemia.
- This study investigates the frequency and implications of aortic wall hyperdensity in patients without clinical or imaging evidence of aortic dissection.
Observation:
- The study analyzed 107 chest CT scans in patients with known hematocrit levels.
- Aortic wall density was assessed in relation to patient age, calcification, and anemia status.
Findings:
- Aortic wall density correlated with patient age and the presence of arterial calcification.
- Anemia was not a statistically significant factor in aortic wall hyperdensity.
- However, marked aortic wall conspicuousness in patients under 60 did suggest anemia.
Implications:
- Atherosclerosis is identified as the most probable cause of aortic wall visibility in nonanemic patients.
- Aortic wall hyperdensity is not a definitive marker for anemia.
- Further research may clarify the relationship between aortic wall changes and hematological conditions.
Abstract:
Opacity of the aortic wall as compared with the nonopacified blood in the lumen has been utilized as one of the criteria for the diagnosis of aortic dissection. It has also been suggested that this finding may be indicative of severe anemia. We evaluated the frequency and implications of aortic wall hyperdensity in 107 consecutive chest CT examinations in patients with no indication of aortic dissection clinically or by other imaging modalities, and whose hematocrit was known. The density of the wall correlated with the patient's age and presence of calcification. Presence or absence of anemia was not a statistically significant factor, although marked conspicuousness of the wall below the age of 60 years did suggest anemia. Atherosclerosis is the most likely explanation for wall visibility in nonanemic patients.
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