CT patterns of mural thrombus in aortic aneurysms

Area of Science:

• Radiology
• Cardiovascular Imaging
• Vascular Surgery

Background:

• Aortic aneurysms, including arteriosclerotic and dissecting types, pose significant clinical challenges.
• Accurate imaging is crucial for diagnosis, characterization, and management planning.
• Computed tomography (CT) is a primary modality for evaluating aortic pathology.

Purpose of the Study:

• To analyze CT findings in patients with arteriosclerotic and/or dissecting aortic aneurysms.
• To characterize the prevalence and patterns of mural thrombus within these aneurysms.
• To assess associated features like aortic deformity and calcification.

Main Methods:

• Retrospective analysis of 71 computed tomography (CT) scans from patients with aortic aneurysms.
• Categorization of aneurysm location (thoracic, abdominal, thoracoabdominal).
• Detailed evaluation of aortic morphology, mural thrombus presence and patterns, and calcification.

Main Results:

• All 71 cases exhibited aortic enlargement; 92% showed aortic deformity.
• Mural thrombus was present in 86% of cases, with eight distinct patterns identified.
• The most common thrombus patterns were ring type (Type A), left crescent (Type H), and left posterior crescent (Type D).
• Calcification was observed in 60 cases, including intraluminal calcification in 14 cases.

Conclusions:

• CT imaging effectively demonstrates enlargement and deformity in arteriosclerotic and/or dissecting aortic aneurysms.
• Mural thrombus is a frequent finding, exhibiting diverse patterns that may have clinical implications.
• Characterization of thrombus patterns, deformity, and calcification on CT aids in comprehensive aneurysm assessment.