Potential interest of intra-aorta ultrasound imaging for the diagnosis of aortic penetrating atherosclerotic ulcer.
A 72-year-old man was admitted to our hospital for acute back pain. Transesophageal echocardiography (TEE), computed tomography (CT) and magnetic resonance imaging (MRI) all showed the presence of intramural hematoma (IMH) located in the descending aorta, with bilateral pleural effusions. The patient was initially referred for medical therapy and 'watchful waiting'. However, he continued to have back pain, so we decided to perform invasive aortography examination and intra-aortic ultrasound (IAU) imaging. No penetrating aortic ulcer (PAU) was found on multiple angiographic views, but intra-aorta ultrasound imaging clearly showed a PAU measuring 3x1 mm(2) in connection with the intramural hematoma. Even retrospective analysis of CT images failed to reveal this PAU. Therefore, we think that IAU imaging may be a useful tool in the diagnosis of PAU.
Wei
Hu
H
Department of Cardiology, University Hospital Jean Minjoz, Besançon, France. jean-pierre.bassand@ufc-chu.univ.fr
Schiele
Francois
F
Meneveau
Nicolas
N
Seronde
Marie-France
MF
Legalery
Pierre
P
Bonneville
Jean-Francois
JF
Chocron
Sidney
S
Bassand
Jean-Pierre
JP
D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D001027:Aortography; D050197:Atherosclerosis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006406:Hematoma / Q000000981:diagnostic imaging; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D036542:Tomography, Spiral Computed; D014456:Ulcer / Q000175:diagnosis / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional