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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Intramural hematoma (IMH)
Definitions
- Acute aortic syndrome comprises aortic dissection (AD), incomplete AD (ID), penetrating aortic ulcer (PAU), and IMH
- IMH (or class 2 AD)
- 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
- ± IMH
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
- Gutschow SE et al: Emerging concepts in intramural hematoma imaging. Radiographics. 36(3):660-74, 2016
- Valente T et al: MDCT distinguishing features of focal aortic projections (FAP) in acute clinical settings. Radiol Med. 120(1):50-72, 2015
- 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
- Wu MT et al: Images in cardiovascular medicine. Multislice computed tomography of aortic intramural hematoma with progressive intercostal artery tears: the Chinese ring-sword sign. Circulation. 111(5):e92-3, 2005
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References
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Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Intramural hematoma (IMH)
Definitions
- Acute aortic syndrome comprises aortic dissection (AD), incomplete AD (ID), penetrating aortic ulcer (PAU), and IMH
- IMH (or class 2 AD)
- 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
- ± IMH
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
- Gutschow SE et al: Emerging concepts in intramural hematoma imaging. Radiographics. 36(3):660-74, 2016
- Valente T et al: MDCT distinguishing features of focal aortic projections (FAP) in acute clinical settings. Radiol Med. 120(1):50-72, 2015
- 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
- Wu MT et al: Images in cardiovascular medicine. Multislice computed tomography of aortic intramural hematoma with progressive intercostal artery tears: the Chinese ring-sword sign. Circulation. 111(5):e92-3, 2005
