CTICasesAortic Intramural Hematoma with Hemopericardium and Intimal Entry Tear
Imaging findings
Chest CT demonstrates a high-attenuation, crescentic thickening of the ascending aortic wall on non-contrast imaging, consistent with an acute intramural hematoma, associated with a high-density hemopericardium. Contrast-enhanced CT reveals a subtle, focal posterior wall irregularity representing the microscopic intimal entry tear.
Key takeaways
An aortic intramural hematoma is a variant of acute aortic syndrome characterized by hemorrhage within the media without a classic patent false lumen. Identifying a subtle intimal entry tear and associated hemopericardium is critical for surgical planning, as these Type A lesions carry a high risk of rupture and require urgent surgical intervention.
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