CTICasesAcute Type B Intramural Hematoma
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Imaging findings
The patient had an acute type B intramural hematoma, visualized as a crescent of high attenuation on CT. A small pool of contrast was noted, suggesting an ulcer-like projection rather than a true penetrating atherosclerotic ulcer, as there was no significant atherosclerosis noted in the aorta. The lesion communicated with intercostal or bronchial arteries, typical of complications associated with intramural hematoma.
Key takeaways
Ulcer-like projections in the setting of acute intramural hematoma represent a complication rather than a primary penetrating atherosclerotic ulcer. Distinguishing these from branch artery pseudoaneurysms is crucial for prognosis, although both entities occur within the acute aortic syndrome spectrum.
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