406.Aortic Intramural Hematoma

每天朗读一段医学影像学英语文章

IMH is a condition characterized by rupture of the vasa vasorum, the network of vessels that supply the aorta itself, resulting in bleeding within the aortic wall, mostly within the media layer.

IMH is clinically indistinguishable from aortic dissection. Patients present with signs of acute aortic syndrome consisting of sudden chest pain that is radiating to the back or chest depending on which part of the aorta is affected. IMH accounts for 10–30 % of cases of acute aortic syndrome, and it may be caused by hypertension, blunt trauma, or penetrating atherosclerotic ulcer. In contrast to aortic dissection, no intimal tear flap is identified in this condition. However, the hematoma can progress into a true dissection if the aortic wall continues to enlarge in thickness by the hematoma >5 cm.

Signs on CTA

On contrast-enhanced scan, the aortic wall show a crescentic area of wall thickening that may show high attenuation if the bleeding is fresh. There is no intimal flap (Fig. 5.1.10).

Fig. 5.1.10 Axial cardiac CTA shows posterior aortic arch focal area of aortic wall thickening due to intramural hematoma (arrowheads).

Notes:

1. intramural /ˌɪntrə'mjʊər(ə)l/ /ˌɪntrə'mjʊrəl/ adj. 内部的

2. hematoma /ˌhiːmə'təʊmə/ /ˌhɛmə'tomɚ/ n. 血肿

3. vasa vasorum 血管壁

4. indistinguishable /ɪndɪ'stɪŋgwɪʃəb(ə)l/ /'ɪndɪ'stɪŋgwɪʃəbl/ adj. 难区分的，不能分辨的

5. aortic dissection 主动脉夹层

6. crescentic 新月形的

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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