Dissecting Aneurysms of the Aorta: Roentgen Manifestations Including a Comparison with Other Types of Aneurysms

New Development of an Ulcerlike Projection in Aortic Intramural Hematoma: CT Evaluation

“…Ulcerlike projection was first described in 1965 as a defect in the intima leading to a clotted second channel, and it has been recognized as one of the radiologic findings in aortic dissection (1)(2)(3)(4)(5). At CT and angiography, the ulcerlike projection appears as a localized blood-filled pouch protruding into the thrombosed lumen of the aorta, showing the same degree of contrast enhancement as the aortic lumen.…”

“…Ulcerlike projections have usually been considered to represent the site of an intimal disruption, such as an intimal tear and penetrating atherosclerotic ulcer (PAU) (1)(2)(3)(4)(5).…”

Coexistent True Aortic Aneurysm as a Cause of Acute Aortic Dissection

“…Ulcer-like projection (ULP) was defined as a localized blood-filled pouch protruding from the true lumen to the thrombosed false lumen. 4,5 The definitions of aortic aneurysm were fusiform type dilatation with the maximal diameter ≥45 mm for the ascending aorta, 40 mm for the aortic arch and descending aorta, and 30 mm for the abdominal aorta (thoracoabdominal aortic aneurysms were classified as descending TAA); and saccular type dilatation regardless of the size or the location. 4 Distinction between coexistent aortic aneurysm and dissecting aortic aneurysm was made based on the findings of 3-dimensional CT reconstruction and was clear in all cases studied (Figure 1).…”

Guidelines for Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection (JCS 2011)

“…Medial deviation of calcification of the intima of the aortic wall is a finding suggestive of dissection. 22 …”