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Published online before print June 28, 2002, 10.1148/radiol.2242011009
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New Development of an Ulcerlike Projection in Aortic Intramural Hematoma: CT Evaluation1

Eijun Sueyoshi, MD, Yohjiro Matsuoka, MD, Tatsuya Imada, MD, Tomoaki Okimoto, MD, Ichiro Sakamoto, MD and Kuniaki Hayashi, MD

1 From the Departments of Radiology (E.S.) and Cardiovascular Surgery (T.I.), Omura Municipal Hospital, Japan; Department of Radiology, National Nagasaki-chuo Hospital, Omura, Japan (Y.M.); and Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8502 Japan (E.S., T.O., I.S., K.H.). Received June 6, 2001; revision requested June 27; final revision received February 4, 2002; accepted February 26. Address correspondence to E.S. (e-mail: eijunsueyoshi@aol.com).



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  		Figure 1a. Type A aortic intramural hematoma in an 81-year-old woman. (a) Initial transverse CT scan shows intramural hematoma formation (arrowheads) from the ascending to the descending aorta. There is no ulcerlike projection. (b) Follow-up transverse CT scan obtained 2 days after a shows a new ulcerlike projection (arrowhead) in the ascending aorta. The ascending aortic intramural hematoma has increased in size. (c) Follow-up transverse CT scan obtained 3 months after b shows enlargement of the ulcerlike projection. After 3 more months, surgery was performed.

 


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  		Figure 1b. Type A aortic intramural hematoma in an 81-year-old woman. (a) Initial transverse CT scan shows intramural hematoma formation (arrowheads) from the ascending to the descending aorta. There is no ulcerlike projection. (b) Follow-up transverse CT scan obtained 2 days after a shows a new ulcerlike projection (arrowhead) in the ascending aorta. The ascending aortic intramural hematoma has increased in size. (c) Follow-up transverse CT scan obtained 3 months after b shows enlargement of the ulcerlike projection. After 3 more months, surgery was performed.

 


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  		Figure 1c. Type A aortic intramural hematoma in an 81-year-old woman. (a) Initial transverse CT scan shows intramural hematoma formation (arrowheads) from the ascending to the descending aorta. There is no ulcerlike projection. (b) Follow-up transverse CT scan obtained 2 days after a shows a new ulcerlike projection (arrowhead) in the ascending aorta. The ascending aortic intramural hematoma has increased in size. (c) Follow-up transverse CT scan obtained 3 months after b shows enlargement of the ulcerlike projection. After 3 more months, surgery was performed.

 


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  		Figure 2a. Type B aortic intramural hematoma in a 75-year-old man. (a) Initial transverse CT scan shows hematoma formation (arrowheads) in the abdominal aorta. There is no ulcerlike projection. (b) Follow-up transverse CT scan obtained 1 day after a shows a new ulcerlike projection (arrowhead) in the abdominal aorta. (c) Follow-up transverse CT scan obtained 6 days after b shows that the ulcerlike projection has disappeared.

 


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  		Figure 2b. Type B aortic intramural hematoma in a 75-year-old man. (a) Initial transverse CT scan shows hematoma formation (arrowheads) in the abdominal aorta. There is no ulcerlike projection. (b) Follow-up transverse CT scan obtained 1 day after a shows a new ulcerlike projection (arrowhead) in the abdominal aorta. (c) Follow-up transverse CT scan obtained 6 days after b shows that the ulcerlike projection has disappeared.

 


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  		Figure 2c. Type B aortic intramural hematoma in a 75-year-old man. (a) Initial transverse CT scan shows hematoma formation (arrowheads) in the abdominal aorta. There is no ulcerlike projection. (b) Follow-up transverse CT scan obtained 1 day after a shows a new ulcerlike projection (arrowhead) in the abdominal aorta. (c) Follow-up transverse CT scan obtained 6 days after b shows that the ulcerlike projection has disappeared.

 




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