An analysis of initial and follow-up CT findings in intramural hematoma, aortic double-lumen dissection, and mixed type lesions

Ibukuro, Kenji; Takeguchi, Takaya; Fukuda, Haruki; Mori, Masaya; Abe, Shoko; Tobe, Kimiko

doi:10.1177/0284185114549824

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…Dreisbach et al [ 28 ] reported the absence of branch involvement in IMH, and Evangelista et al [ 29 ] also suggested that IMH is unlikely to be poorly perfused. But Ibukuro et al [ 30 ] proposed that the probability of branch artery involvement in IMH was 12.9%.In our study, 7 patients with IMH-like lesions had renal artery involvement, with an incidence rate of 16.7% (7/42), which is higher than previous reports. We comparatively analysed the imaging findings of IMH patients with branch involvement and AD patients with branch involvement and found that all IMH-like lesions patients showed different degrees of renal artery involvement and that severe cases had no contrast agent in the lumen of the initial part of the right renal artery but had right renal ischaemia.…”

Section: Discussioncontrasting

confidence: 73%

Clinical and imaging differences between Stanford Type B intramural hematoma-like lesions and classic aortic dissection

Wei

et al. 2023

BMC Cardiovasc Disord

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Background Intramural hematoma (IMH) and Aortic dissection (AD) have overlapping features. The aim of this study was to explore the differences between them by comparing the clinical manifestations and imaging features of patients with acute Stanford type B IMH-like lesions and acute Stanford type B AD (ATBAD). Methods This study retrospectively analysed the clinical and computed tomography angiography (CTA) imaging data of 42 IMH-like lesions patients with ulcer-like projection (ULP) and 38 ATBAD patients, and compared their clinical and imaging features. Results (1) The IMH-like lesions patients were older than the ATBAD patients (64.2 ± 11.5 vs. 50.9 ± 12.2 years, P < 0.001). The D-dimer level in the IMH-like lesions group was significantly higher than that in the ATBAD group (11.2 ± 3.6 vs. 9.2 ± 4.5 mg/L, P < 0.05). The incidence rate of back pain was significantly higher in the ATBAD group than in the IMH-like lesions group (71.1% vs. 26.2%, P < 0.05). (2) The ULPs of IMH-like lesions and the intimal tears of ATBAD were concentrated in zone 4 of the descending thoracic aorta. The ULPs of IMH-like lesions and the intimal tears of ATBAD were mainly in the upper quadrant outside the lumen (64.3% vs. 65.8%, P > 0.05). (3) The maximum diameter of the ULPs in IMH-like lesions was smaller than that of the intimal tears in ATBAD (7.4 ± 3.4 vs. 10.8 ± 6.8 mm, P = 0.005). The lumen compression ratio in the ULPs plane and the maximum compression ratio of the aortic lumen in the IMH-like lesions group were smaller than that in the ADBAD group (P < 0.05). Fewer aortic segments were involved in IMH-like lesions patients than in ATBAD patients (5.6 ± 2.2 vs. 7.1 ± 1.9 segments, P < 0.005). The IMH-like lesions group had less branch involvement than that of the ATBAD group (P < 0.001). Conclusion The degree of intimal tears, lumen compression ratio, extent of lesion involvement, and impact on branch arteries in ATBAD are more severe than that of IMH-like lesions. But for the ULPs of IMH-like lesions and intimal tears of ATBAD, they have astonishing similarities in the location of the partition and the lumen quadrant, we have reason to believe that intimal tear is the initial factor in the pathogenesis of this kind of disease, and their clinical and imaging manifestations overlap, but the severity is different. Concerning similarities between these two conditions, these two may be a spectrum of one disease.

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Section: Discussioncontrasting

confidence: 73%

Clinical and imaging differences between Stanford Type B intramural hematoma-like lesions and classic aortic dissection

Wei

et al. 2023

BMC Cardiovasc Disord

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Should the distal tears of aortic dissection be treated? The risk of distal tears after proximal repair of aortic dissection

Zhang

Chen

Zhang

et al. 2018

International Journal of Cardiology

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An analysis of initial and follow-up CT findings in intramural hematoma, aortic double-lumen dissection, and mixed type lesions

Abstract: There is a distinct difference between IMH and AD in distal extension; however, the locations of the lesions are pathologically the same in the media of the aorta.

Cited by 2 publications

References 21 publications

Clinical and imaging differences between Stanford Type B intramural hematoma-like lesions and classic aortic dissection

Clinical and imaging differences between Stanford Type B intramural hematoma-like lesions and classic aortic dissection

Should the distal tears of aortic dissection be treated? The risk of distal tears after proximal repair of aortic dissection

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