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Intramural Blood Pools in Aortic Intramural Hematoma

Imaging findings

CT angiography shows a thoracic aortic intramural hematoma containing multiple, distinct, focal contrast collections (intramural blood pools) that are fed by and communicate with the adjacent intercostal and bronchial arteries.

Key takeaways

Intramural blood pools (ILBs) are localized areas of contrast enhancement within an IMH. They typically represent small pseudoaneurysms at the origins of aortic branch vessels (intercostal/bronchial arteries) caused by shearing forces. They are generally benign and run a stable clinical course.

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