CTICasesAcute Aortic Intramural Hematoma with Intimal Tear
Imaging findings
Non-contrast CT reveals findings typical of acute intramural hematoma (IMH), involving both the ascending and descending aorta, with displacement of intimal calcifications. Contrast-enhanced CT, particularly on thin cuts, exquisitely demonstrates at least one clear intimal tear where contrast medium passes from the aortic lumen into the aortic wall and the intramural hematoma, with a possible second tear identified.
Key takeaways
This case provides a clear demonstration of acute aortic intramural hematoma with an identifiable intimal tear, a phenomenon increasingly recognized in IMH cases. The presence of an intimal tear challenges the traditional understanding of IMH as solely originating from vasa vasorum rupture, suggesting a spectrum of aortic dissection.
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