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VCU Department of Radiology

VCU Medical Center

Case of the Week: May 29-June 5, 2020

80 yo female presents to the ER with 2 day history of back pain. Two static images, without and with contrast enhancement, from CTA Chest are presented.

What is your diagnosis?

(Click for a larger image.)

Case Details

.

The first non-contrast enhanced image demonstrates an IMH or intramural hematoma. The second, contrast-enhanced, image demonstrates IMBP or intramural blood pool(s), also known as intramural branch artery psuedoaneurysm(s).

Answer

Diagnosis: Intramural Hematoma

Both IMH and IMBP, along with PAU or penetrating atherosclerotic ulcer, and aortic dissection are included in the category of acute aortic syndrome.

This patient went on to endovascular stent grafting of the thoracic aorta with coverage and occlusion of the left subclavian artery, with left common carotid to subclavian bypass.

Reference: 

Radiographics. Emerging Concepts in IMH Imaging. May 10 2016 https://doi.org/10.1148/rg.2016150094

Correct answers by users

Radiology Medicine/Pulmonary
VCU Resident
Samarth Gola
Syed Reza
Son Vo
Others
NADEEM AHMED India
Hatem Ahmed adham Saudi Arabia
Adam Algazali Yemen
Francesco Buemi Italy
Rajesh Gothi India
Meisam Izadi Iran
Robert Kennedy United States of America
Robert Palmer United States of America
Pradosh kumar Sarangi India
Alexandra Uhrinová Slovakia
Genchi Vincenzo Italy
Arushi Yadav India
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Summary | 8 Annotations
intramural hematoma
2020/11/12 18:51
The first
2020/11/12 18:51
The second
2020/11/12 18:52
IMBP or intramural blood pool(s), also known as intramural branch artery psuedoaneurysm(s).
2020/11/12 18:52
Diagnosis
2020/11/12 18:54
Intramural Hematoma
2020/11/12 18:54
Both IMH and IMBP, along with PAU or penetrating atherosclerotic ulcer, and aortic dissection are included in the category of
2020/11/12 18:54
acute aortic syndrome.
2020/11/12 18:55