Natural History and CT Appearances of Aortic Intramural Hematoma
Natural History and CT Appearances of Aortic Intramural Hematoma
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DOI：
10.1148/rg.293085122
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发表时间：
2009-05-01
期刊：
影响因子：
5.5
通讯作者：
Kalva, Sanjeeva P.
中科院分区：
文献类型：
--
作者：
Chao, Christine P.;Walker, T. Gregory;Kalva, Sanjeeva P.
滋养血管破裂进入主动脉壁中层导致主动脉壁内血肿。主动脉壁内血肿的特征性表现包括平扫计算机断层扫描 (CT) 中的新月形高密度液体积聚，以及造影剂增强 CT 中主动脉壁的光滑、非增强增厚。未经治疗的壁内血肿的 CT 表现会随着时间的推移而变化，衰减的减少是血肿慢性化的线索。 CT 对于评估主动脉壁内血肿特别有用，因为它可以将其与具有相似临床表现的主动脉夹层区分开来，并可以准确确定其位置 - 对于手术计划至关重要的信息。根据 CT 检查结果，一些血肿可能会自行消退，而另一些血肿则可能被认为存在发生主动脉夹层、动脉瘤和破裂等严重并发症的高风险。准确识别诊断特异性 CT 特征并了解其重要性有助于适当的临床管理。 (C) RSNA，2009 年。radigraphics.rsnajnls.org
Rupture of the vasa vasorum into the media of the aortic wall results in an aortic intramural hematoma. Characteristic findings of an aortic intramural hematoma include a crescentic hyperattenuating fluid collection at unenhanced computed tomography (CT) and a smooth, nonenhancing, thickened aortic wall at contrast material-enhanced CT. The CT appearance of untreated intramural hematomas evolves over time, and decreased attenuation is a clue to the chronicity of a hematoma. CT is particularly useful for evaluating aortic intramural hematomas because it allows their differentiation from aortic dissections, which have similar clinical manifestations, and permits an exact determination of their location-crucial information for surgical planning. On the basis of CT findings, some hematomas may be expected to resolve spontaneously, whereas others may be identified as posing a high risk for serious complications such as aortic dissection, aneurysm, and rupture. Appropriate clinical management is aided by accurate recognition of diagnostically specific CT features and awareness of their significance. (C) RSNA, 2009. radiographics.rsnajnls.org