| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Radiology, Vol 183, 759-765, Copyright © 1992 by Radiological Society of North America
ARTICLES |
EA Kazerooni, RL Bree and DM Williams
Department of Radiology, University of Michigan Hospitals, Ann Arbor 48109-1432.
Penetrating atherosclerotic ulceration of the aorta is a poorly understood entity that clinically mimics classic aortic dissection but has imaging features that are distinctly different. In a review of 16 patients with penetrating atherosclerotic ulceration, patients were typically hypertensive (n = 14), and they experienced chest or back pain (n = 13). All patients had an abnormal chest radiograph, with diffuse (n = 14) or focal (n = 2) enlargement of the descending thoracic aorta. Features at contrast material-enhanced computed tomography (CT) included intramural hematoma (n = 16), focal ulcer (n = 15), displaced intimal calcification (n = 13), pleural and/or extrapleural fluid (n = 7), mediastinal fluid (n = 4), and a thick or enhancing aortic wall (n = 6). The chest radiograph and CT findings were compared in patients treated conservatively (n = 9) and surgically (n = 7). These findings did not correlate with the need for surgery. Eight of nine conservatively treated patients were asymptomatic after treatment with antihypertensive medication. Contiguous dynamic contrast- enhanced CT of the aorta enables distinction of ulceration from dissection, which is particularly important in the hemodynamically unstable patient because the surgical management of ulceration is more extensive than that for aortic dissection.
This article has been cited by other articles:
|
|
 |
|
  P. F. Ford and M. A. Farber Role of Endovascular Therapies in the Management of Diverse Thoracic Aortic Pathology Perspectives in Vascular Surgery and Endovascular Therapy, June 1, 2007; 19(2): 134 - 143. [Abstract] [PDF]
|
|
|
|
 |
|
 T. M. Sundt Intramural Hematoma and Penetrating Atherosclerotic Ulcer of the Aorta Ann. Thorac. Surg., February 1, 2007; 83(2): S835 - S841. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M R Jones and J H Reid Emergency chest radiology: thoracic aortic disease and pulmonary embolism Imaging, September 1, 2006; 18(3): 122 - 138. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Makita, A. Ohira, Y. Naganuma, Y. Moriai, H. Niinuma, A. Abiko, and K. Hiramori Increased Carotid Artery Stiffness Without Atherosclerotic Change in Patients With Aortic Dissection Angiology, August 1, 2006; 57(4): 478 - 486. [Abstract] [PDF]
|
|
|
|
 |
|
 R. G. Hayter, J. T. Rhea, A. Small, F. S. Tafazoli, and R. A. Novelline Suspected Aortic Dissection and Other Aortic Disorders: Multi-Detector Row CT in 373 Cases in the Emergency Setting Radiology, March 1, 2006; 238(3): 841 - 852. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. T. O'Gara, A. J. Greenfield, N. A. Afridi, and S. L. Houser Case 12-2004 - A 38-Year-Old Woman with Acute Onset of Pain in the Chest N. Engl. J. Med., April 15, 2004; 350(16): 1666 - 1674. [Full Text] [PDF]
|
|
|
|
 |
|
 E. Castaner, M. Andreu, X. Gallardo, J. M. Mata, M. A. Cabezuelo, and Y. Pallardo CT in Nontraumatic Acute Thoracic Aortic Disease: Typical and Atypical Features and Complications RadioGraphics, October 1, 2003; 23(90001): S93 - 110. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Ganaha, D. C. Miller, K. Sugimoto, Y. S. Do, H. Minamiguchi, H. Saito, R. S. Mitchell, and M. D. Dake Prognosis of Aortic Intramural Hematoma With and Without Penetrating Atherosclerotic Ulcer: A Clinical and Radiological Analysis Circulation, July 16, 2002; 106(3): 342 - 348. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. A. Khan and C. K. Nair Clinical, Diagnostic, and Management Perspectives of Aortic Dissection* Chest, July 1, 2002; 122(1): 311 - 328. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. E. Quint, D. M. Williams, I. R. Francis, H. M. Monaghan, S. S. Sonnad, S. Patel, and G. M. Deeb Ulcerlike Lesions of the Aorta: Imaging Features and Natural History Radiology, March 1, 2001; 218(3): 719 - 723. [Abstract] [Full Text]
|
|
|
|
|
|
R. H. Mohiaddin, J. McCrohon, J. M. Francis, M. Barbir, and D. J. Pennell Contrast-Enhanced Magnetic Resonance Angiogram of Penetrating Aortic Ulcer Circulation, January 30, 2001; 103 (4): e18 - e19. [Full Text] [PDF]
|
|
|
|
|
|
H. Hayashi, Y. Matsuoka, I. Sakamoto, E. Sueyoshi, T. Okimoto, K. Hayashi, and N. Matsunaga Penetrating Atherosclerotic Ulcer of the Aorta: Imaging Features and Disease Concept RadioGraphics, July 1, 2000; 20(4): 995 - 1005. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Batra, B. Bigoni, J. Manning, D. R. Aberle, K. Brown, E. Hart, and J. Goldin Pitfalls in the Diagnosis of Thoracic Aortic Dissection at CT Angiography RadioGraphics, March 1, 2000; 20(2): 309 - 320. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kaji, K. Nishigami, T. Akasaka, T. Hozumi, T. Takagi, T. Kawamoto, H. Okura, H. Shono, Y. Horibata, T. Honda, et al. Prediction of Progression or Regression of Type A Aortic Intramural Hematoma by Computed Tomography Circulation, November 9, 1999; 100(90002): II-281 - 286. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Sebastia, E. Pallisa, S. Quiroga, A. Alvarez-Castells, R. Dominguez, and A. Evangelista Aortic Dissection: Diagnosis and Follow-up with Helical CT RadioGraphics, January 1, 1999; 19(1): 45 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Vilacosta, J. A. San Roman, P. Aragoncillo, J. Ferreiros, R. Mendez, C. Graupner, E. Batlle, J. Serrano, A. Pinto, and J. M. Oyonarte Penetrating atherosclerotic aortic ulcer: documentation by transesophageal echocardiography J. Am. Coll. Cardiol., July 1, 1998; 32(1): 83 - 89. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Moriyama, G. Yotsumoto, K. Kuriwaki, S. Watanabe, K. Hisatomi, S. Shimokawa, H. Toyohira, and A. Taira Intramural hematoma of the thoracic aorta Eur. J. Cardiothorac. Surg., March 1, 1998; 13(3): 230 - 239. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Harris, A. C. Braverman, F. R. Gutierrez, B. Barzilai, and V. G. Davila-Roman TRANSESOPHAGEAL ECHOCARDIOGRAPHIC AND CLINICAL FEATURES OF AORTIC INTRAMURAL HEMATOMA J. Thorac. Cardiovasc. Surg., October 1, 1997; 114(4): 619 - 626. [Abstract] [Full Text]
|
|
|
|
|
|
Y. Moriyama, K. Shiota, K. Hisatomi, S. Watanabe, H. Saigenji, S. Shimokawa, H. Toyohira, A. Taira, and Y. Moriyama Acute Type A Aortic Dissection Following Intramural Hematoma of the Aorta: A Case Report Angiology, September 1, 1997; 48(9): 839 - 841. [Abstract] [PDF]
|
|
|
|
|
|
M. Kato, H.-z. Bai, K. Sato, S. Kawamoto, M. Kaneko, T. Ueda, D. Kishi, and K. Ohnishi Determining Surgical Indications for Acute Type B Dissection Based on Enlargement of Aortic Diameter During the Chronic Phase Circulation, November 1, 1995; 92(9): 107 - 112. [Abstract] [Full Text]
|
|
|
|
|
|
P. T. O'Gara and R. W. DeSanctis Acute Aortic Dissection and Its Variants : Toward a Common Diagnostic and Therapeutic Approach Circulation, September 15, 1995; 92(6): 1376 - 1378. [Full Text]
|
|
|
|
|
|
C. A. Nienaber, Y. von Kodolitsch, B. Petersen, R. Loose, U. Helmchen, A. Haverich, and R. P. Spielmann Intramural Hemorrhage of the Thoracic Aorta : Diagnostic and Therapeutic Implications Circulation, September 15, 1995; 92(6): 1465 - 1472. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| RADIOLOGY | RADIOGRAPHICS | RSNA JOURNALS ONLINE |
