CT diagnosis and destiny of acute aortic intramural hematoma
Acute aortic intramural hematoma (IMH) is a relatively uncommon but potentially life-threatening aortic disease that can occur primarily in hypertensive and atherosclerotic patients. The course of IMH varies widely, with the condition either regressing, remaining stable, or progressing until it lead...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Radiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fradi.2025.1552644/full |
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| author | Giacomo Sica Gaetano Rea Roberta Lieto Mariano Scaglione Ahmad Abu-Omar Giorgio Bocchini Federica Romano Salvatore Masala Stefania Tamburrini Salvatore Guarino Candida Massimo Tullio Valente |
| author_facet | Giacomo Sica Gaetano Rea Roberta Lieto Mariano Scaglione Ahmad Abu-Omar Giorgio Bocchini Federica Romano Salvatore Masala Stefania Tamburrini Salvatore Guarino Candida Massimo Tullio Valente |
| author_sort | Giacomo Sica |
| collection | DOAJ |
| description | Acute aortic intramural hematoma (IMH) is a relatively uncommon but potentially life-threatening aortic disease that can occur primarily in hypertensive and atherosclerotic patients. The course of IMH varies widely, with the condition either regressing, remaining stable, or progressing until it leads to outward rupture or intimal layer disruption, eventually resulting in overt aortic dissection. Therefore, poor prognostic computed tomography (CT) features must be promptly recognized and reported by the radiologist. In emergency departments, readily accessible non-invasive CT angiography is crucial for achieving a rapid and accurate diagnosis essential for appropriate management. For Type A and B aortic dissection, surgery is typically recommended in Western countries for patients with Stanford Type A IMH and those experiencing irrepressible pain. For Stanford Type B IMH patients without complications or incessant pain, medical treatment is suggested but with imaging follow-up. In complicated Stanford Type B situations, thoracic endovascular aortic repair (TEVAR) is currently indicated. This review aims to present pathophysiology, CT diagnosis, and IMH fate and provide the reader CT image-based review of the CT diagnostic criteria, complications, and associated critical prognostic findings of this rather rare aortic disease. |
| format | Article |
| id | doaj-art-e094a5a481314c1f8a2657201f535825 |
| institution | DOAJ |
| issn | 2673-8740 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Radiology |
| spelling | doaj-art-e094a5a481314c1f8a2657201f5358252025-08-20T02:57:53ZengFrontiers Media S.A.Frontiers in Radiology2673-87402025-03-01510.3389/fradi.2025.15526441552644CT diagnosis and destiny of acute aortic intramural hematomaGiacomo Sica0Gaetano Rea1Roberta Lieto2Mariano Scaglione3Ahmad Abu-Omar4Giorgio Bocchini5Federica Romano6Salvatore Masala7Stefania Tamburrini8Salvatore Guarino9Candida Massimo10Tullio Valente11Department of Radiology, Azienda dei Colli, Monaldi Hospital, Naples, ItalyDepartment of Radiology, Azienda dei Colli, Monaldi Hospital, Naples, ItalyDepartment of Radiology, Azienda dei Colli, Monaldi Hospital, Naples, ItalyDepartment of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, ItalyDepartment of Emergency Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC, CanadaDepartment of Radiology, Azienda dei Colli, Monaldi Hospital, Naples, ItalyDepartment of Radiology, Azienda dei Colli, Monaldi Hospital, Naples, ItalyDepartment of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, ItalyDepartment of Radiology, Ospedale del Mare-ASL NA1 Centro, Napoli, ItalyDepartment of Radiology, Azienda dei Colli, Monaldi Hospital, Naples, ItalyDepartment of Radiology, Azienda dei Colli, Monaldi Hospital, Naples, ItalyDepartment of Radiology, Azienda dei Colli, Monaldi Hospital, Naples, ItalyAcute aortic intramural hematoma (IMH) is a relatively uncommon but potentially life-threatening aortic disease that can occur primarily in hypertensive and atherosclerotic patients. The course of IMH varies widely, with the condition either regressing, remaining stable, or progressing until it leads to outward rupture or intimal layer disruption, eventually resulting in overt aortic dissection. Therefore, poor prognostic computed tomography (CT) features must be promptly recognized and reported by the radiologist. In emergency departments, readily accessible non-invasive CT angiography is crucial for achieving a rapid and accurate diagnosis essential for appropriate management. For Type A and B aortic dissection, surgery is typically recommended in Western countries for patients with Stanford Type A IMH and those experiencing irrepressible pain. For Stanford Type B IMH patients without complications or incessant pain, medical treatment is suggested but with imaging follow-up. In complicated Stanford Type B situations, thoracic endovascular aortic repair (TEVAR) is currently indicated. This review aims to present pathophysiology, CT diagnosis, and IMH fate and provide the reader CT image-based review of the CT diagnostic criteria, complications, and associated critical prognostic findings of this rather rare aortic disease.https://www.frontiersin.org/articles/10.3389/fradi.2025.1552644/fullaortic intramural hematomacomputed tomography angiography (CTA)acute aortic syndrome (AAS)penetrating atherosclerotic ulcer (PAU)aortic dissection (AD)diagnosis |
| spellingShingle | Giacomo Sica Gaetano Rea Roberta Lieto Mariano Scaglione Ahmad Abu-Omar Giorgio Bocchini Federica Romano Salvatore Masala Stefania Tamburrini Salvatore Guarino Candida Massimo Tullio Valente CT diagnosis and destiny of acute aortic intramural hematoma Frontiers in Radiology aortic intramural hematoma computed tomography angiography (CTA) acute aortic syndrome (AAS) penetrating atherosclerotic ulcer (PAU) aortic dissection (AD) diagnosis |
| title | CT diagnosis and destiny of acute aortic intramural hematoma |
| title_full | CT diagnosis and destiny of acute aortic intramural hematoma |
| title_fullStr | CT diagnosis and destiny of acute aortic intramural hematoma |
| title_full_unstemmed | CT diagnosis and destiny of acute aortic intramural hematoma |
| title_short | CT diagnosis and destiny of acute aortic intramural hematoma |
| title_sort | ct diagnosis and destiny of acute aortic intramural hematoma |
| topic | aortic intramural hematoma computed tomography angiography (CTA) acute aortic syndrome (AAS) penetrating atherosclerotic ulcer (PAU) aortic dissection (AD) diagnosis |
| url | https://www.frontiersin.org/articles/10.3389/fradi.2025.1552644/full |
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