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Intramural blood pools accompanying aortic intramural hematoma: CT appearance and natural course

Ming-Ting Wu1, Yen-Chi Wang, Yi-Luan Huang

  • 1Department of Radiology, Section of Thoracic and Circulation Imaging, Division of Cardiovascular Surgery, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan. wu.mingting@gmail.com

Radiology
|January 8, 2011
PubMed

Insights

Intramural blood pools (IBPs) are common in acute intramural hematoma (IMH) and can appear or resolve over time. These findings on multidetector CT do not indicate a poor prognosis and differ from ulcerlike projections.

Area of Science:

  • Radiology
  • Cardiovascular Imaging
  • Vascular Medicine

Background:

  • Acute intramural hematoma (IMH) is a serious vascular condition.
  • Intramural blood pools (IBPs) are a potential finding within IMH.
  • Understanding IBP characteristics is crucial for patient management.

Purpose of the Study:

  • To evaluate multidetector computed tomographic (CT) imaging for investigating the prevalence, morphology, natural course, and prognostic significance of intramural blood pools (IBPs) in patients with acute intramural hematoma (IMH).

Main Methods:

  • Sixty-five patients with acute IMH were enrolled for follow-up using multidetector CT for at least 12 months.
  • Logistic regression was used to analyze factors associated with IBP development and resorption.
  • Exclusion criteria included patients who underwent surgery.

Main Results:

  • Intramural blood pools (IBPs) were observed in 28% of patients, most commonly in the descending thoracic and abdominal aorta.
  • New IBPs developed during follow-up in some patients.
  • Factors associated with IBP development included younger age and greater IMH wall thickness; incomplete resorption was linked to larger transmural diameter and connection to arteries.

Conclusions:

  • Intramural blood pools (IBPs) are frequently detected by multidetector CT in patients with acute intramural hematoma (IMH).
  • IBPs can emerge during follow-up or resolve spontaneously.
  • The presence of IBPs is not associated with a poor prognosis and should be differentiated from ulcerlike projections.
Abstract

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