CTICasesAortic Intramural Hematoma with Ulcer-Like Projection
Imaging findings
Sequential CT without and with contrast in a patient with known type B intramural hematoma (IMH) demonstrate a circumferential high-attenuation rind on non-contrast imaging. Follow-up CT shows development of a focal ulcer-like projection (ULP) with a broad neck arising from the IMH, along with a separate intramural blood pool, with overall aortic enlargement compared to the prior study.
Key takeaways
Ulcer-like projections (ULPs) are focal outpouchings of contrast that develop within an aortic intramural hematoma, representing contained focal disruption of the intima. They are associated with a markedly worse prognosis than IMH without ULPs, including higher rates of aortic expansion and rupture. ULPs mandate prompt consideration of endovascular repair, distinguishing them from simple IMH which may be managed medically.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Pulmonary Nocardia nova Infection in an Immunocompetent HostInfection
- Disseminated Blastomycosis with Miliary PatternInfection
- Histoplasmosis Lymphadenitis with Milk of CalciumInfection
- Scleroderma ILD with Lymphadenopathy and Progressive Mediastinal Lymph Node CalcificationAutoimmune
- Pulmonary Infarction (Blood-Orange Pattern)Vascular
- Pneumocystis jirovecii Pneumonia (PCP) in a Rheumatoid Arthritis Patient on AdalimumabInfection
- Rhinovirus Pneumonia in a Lung Transplant RecipientInfection
- Pulmonary AL Amyloidosis with Cystic DestructionMetabolic
See all cases from March 4, 2021 →
Related Vascular cases
- Limited (Incomplete) Aortic Dissection with Progressive Evolution
- Asymmetric Pulmonary Edema in a Lung Transplant Recipient with Emphysema (Pseudo-PE Phenomenon)
- Massive Pulmonary Embolism Mimicking Hilar Adenopathy
- Pulmonary Capillary Hemangiomatosis in Scleroderma
- In Situ Pulmonary Artery Thrombosis in Pulmonary Arterial Hypertension
- Acute LAD Occlusion with Zero Calcium Score