CTICasesIntramural Hematoma of the Ascending Aorta with Evolution to an Ulcer-Like Projection
[...]. Intramural Hematoma of the Ascending Aorta with Evolution to an Ulcer-Like Projection. CTICases. Published April 20, 2017. https://str-case-explorer.pages.dev/c/vkp6c
Imaging findings
Serial chest radiography shows interval widening of the right-convex mediastinal interface. Contrast-enhanced CT angiogram reveals a large, wide-necked, ulcer-like projection extending from the ascending aorta, accompanied by non-opacified thrombus or hematoma. Retrospective evaluation of a prior low-dose non-contrast CT from a SPECT V/Q scan demonstrates a hyperattenuating intramural hematoma (IMH) of the ascending aorta in the exact region where the ulcer-like projection subsequently developed.
Key takeaways
Intramural hematoma (IMH) of the aorta is a dynamic acute aortic syndrome that can evolve over time into an ulcer-like projection (ULP) or a frank pseudoaneurysm. Unlike traditional penetrating atherosclerotic ulcers (PAUs), which occur in the setting of severe atherosclerosis and are typically confined to the descending or abdominal aorta, ULPs can develop in the ascending aorta following an acute IMH without underlying atherosclerotic plaque.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Venous Air Embolism and Non-Cardiogenic Pulmonary EdemaIatrogenic
- Myotonic Dystrophy Type 1 with Diaphragmatic and Skeletal Muscle AtrophyCongenital
- Acute Aortic Intramural Hematoma with Intimal-Medial BreachAorta & Arteries
- Subclavian Artery Thrombosis due to Anomalous First RibAorta & Arteries
- Silicosis with Progressive Massive FibrosisExposure
- Plastic BronchitisOther
- Ruptured Type B Aortic Dissection and Bilateral Partial Anomalous Pulmonary Venous ReturnAorta & Arteries
- Left Ventricular Outflow Tract Obstruction by Mitral Valve BioprosthesisValvular
See all cases from April 20, 2017 →
Related Aorta & Arteries cases
- Penetrating Aortic Injury from a Nail Gun
- Circumflex Right Aortic Arch
- Focal Aortic Root Dissection in Systemic Lupus Erythematosus
- Traumatic Ascending Aortic Pseudoaneurysm and Sternal Fracture
- Anastomotic Pseudoaneurysm after Aortic Aneurysm Repair in Marfan Syndrome
- Iatrogenic Aortic Dissection from Catheter Ablation