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Aortic dissection without intimal rupture: diagnosis with MR imaging and CT

T Yamada1, S Tada, J Harada

  • 1Department of Radiology, Jikei University School of Medicine, Tokyo, Japan.

Radiology
|August 1, 1988
PubMed

Insights

Aortic dissection can occur without intimal rupture, presenting as intramural hemorrhage. This condition, diagnosed via imaging and autopsy, resolves within a year.

Area of Science:

  • Cardiovascular Imaging
  • Vascular Surgery
  • Diagnostic Radiology

Background:

  • Aortic dissection is a serious condition often associated with intimal tears.
  • The precise etiology and imaging characteristics of aortic dissection without intimal rupture require further elucidation.

Purpose of the Study:

  • To investigate the imaging findings and natural history of aortic dissection presenting without intimal rupture.
  • To correlate imaging findings with pathological evidence in cases of suspected intramural hemorrhage.

Main Methods:

  • Retrospective analysis of fourteen patients with suspected aortic dissection without intimal rupture.
  • Utilized magnetic resonance (MR) imaging and computed tomography (CT) for diagnosis.
  • Correlated imaging findings with autopsy results in two cases.

Main Results:

  • MR imaging revealed a marginal high-intensity area along the aortic wall.
  • CT demonstrated a nonopacified crescentic area adjacent to the aortic wall.
  • These abnormalities showed a decrease in size over time, normalizing within one year.
  • Autopsies confirmed intramural hemorrhage without intimal tears.

Conclusions:

  • Aortic dissection can arise from intramural hemorrhage due to vasa vasorum rupture, independent of intimal tears.
  • Imaging findings of intramural hematoma are distinct and resolve over time.
  • This entity represents a specific form of aortic dissection.

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