Fate of intramural hematoma of the aorta: CT evaluation.
OBJECTIVE
Our goal was to investigate the fate of intramural hematoma of the aorta.


METHODS
In 32 patients with intramural hematoma of the aorta, we reviewed CT (n = 32) and MR (n = 22) findings. The diagnosis was established by CT, and regular follow-up studies were performed.


RESULTS
All intramural hematomas decreased in size. Ulcer-like projections (ULPs) were identified at the initial study in 6 patients and during the follow-up period in 14 patients. The ULPs progressed to saccular aneurysm in 12 patients (mean 47.0 days), while fusiform aneurysm developed in 6 patients (mean 347.7 days) without ULP. In two patients, the affected aorta progressed to overt aortic dissection.


CONCLUSIONS
Intramural hematoma itself usually decreases in size. However, the affected aorta can progress to aneurysm or overt aortic dissection. Development of saccular aneurysm from ULPs can be considered an early complication. In cases without ULP, fusiform aneurysm may develop as a late complication. All intramural hematomas need to be followed since it seems to be difficult to predict the exact fate of intramural hematoma from the initial imaging findings.
Sueyoshi
E
E
Department of Radiology, Nagasaki University School of Medicine, Japan.
Matsuoka
Y
Y
Sakamoto
I
I
Uetani
M
M
Hayashi
K
K
Narimatsu
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed