Aortic media hemorrhage from spontaneous vasa vasorum rhexis or, occasionally, trauma
Absent or very small entrance tear and absent reentrance tear
a.k.a. noncommunicating dissection
PAU (or class 4 AD)
Ulcerated atherosclerotic lesion that penetrates internal elastic lamina
Associated with variable amounts of intramural hemorrhage
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Echocardiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Akin I et al: Penetrating aortic ulcer, intramural hematoma, acute aortic syndrome: when to do what. J Cardiovasc Surg (Torino). 53(1 Suppl 1):83-90, 2012
Harris KM et al: Acute aortic intramural hematoma: an analysis from the International Registry of Acute Aortic Dissection. Circulation. 126(11 Suppl 1):S91-6, 2012
Kitai T et al: Detection of intimal defect by 64-row multidetector computed tomography in patients with acute aortic intramural hematoma. Circulation. 124(11 Suppl):S174-8, 2011
Wu MT et al: Intramural blood pools accompanying aortic intramural hematoma: CT appearance and natural course. Radiology. 258(3):705-13, 2011
Vilacosta I et al: Acute aortic syndrome: a new look at an old conundrum. Postgrad Med J. 86(1011):52-61, 2010
Aortic media hemorrhage from spontaneous vasa vasorum rhexis or, occasionally, trauma
Absent or very small entrance tear and absent reentrance tear
a.k.a. noncommunicating dissection
PAU (or class 4 AD)
Ulcerated atherosclerotic lesion that penetrates internal elastic lamina
Associated with variable amounts of intramural hemorrhage
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Echocardiographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Akin I et al: Penetrating aortic ulcer, intramural hematoma, acute aortic syndrome: when to do what. J Cardiovasc Surg (Torino). 53(1 Suppl 1):83-90, 2012
Harris KM et al: Acute aortic intramural hematoma: an analysis from the International Registry of Acute Aortic Dissection. Circulation. 126(11 Suppl 1):S91-6, 2012
Kitai T et al: Detection of intimal defect by 64-row multidetector computed tomography in patients with acute aortic intramural hematoma. Circulation. 124(11 Suppl):S174-8, 2011
Wu MT et al: Intramural blood pools accompanying aortic intramural hematoma: CT appearance and natural course. Radiology. 258(3):705-13, 2011
Vilacosta I et al: Acute aortic syndrome: a new look at an old conundrum. Postgrad Med J. 86(1011):52-61, 2010
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