[Intramural hemorrhage of the thoracic aorta].
OBJECTIVE
Intramural hemorrhage (IMH) of the aorta is considered to be a possible preliminary stage to dissection. We report on our experience with MRI, CT, and TEE in the diagnosis as well as in the correct evaluation of the extent of an IMH.


METHODS
Between 1983 and 1997 a total of 26 patients were examined using MRI (n = 13) and/or contrast enhanced CT (n = 18) or TEE. The validation was effected in 17 cases through intraoperative or postmortem inspection and in the remaining cases either through continuous clinical or radiological monitoring (n = 6) or through the depiction of the results in 2 different imaging procedures (n = 3).


RESULTS
The correct diagnosis of an IMH was made on all examined patients with all imaging modalities. In all cases, MRI enabled the correct identification of the affected aortic segments. Using CT the affected descending aorta was overlooked in one out of 15 cases; TEE failed in one out of two cases of intramural hemorrhage in the aortic arch. A false positive diagnosis was made with CT in one out of 9 cases in the ascending aorta, and using sonography, this occurred in two out of 3 cases in the area of the aortic arch.


CONCLUSIONS
According to our experience, magnetic resonance imaging is the most accurate method for the diagnosis of an IMH.
Dieckmann
C
C
Radiologische Klinik, Abteilung Röntgendiagnostik.
von Kodolitsch
Y
Y
Habermann
C R
CR
Csösz
S
S
Loose
R
R
Haverich
A
A
Nicolas
V
V
Nienaber
C A
CA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D017548:Echocardiography, Transesophageal; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
Intramurale Hämorrhagie der thorakalen Aorta.