Wei Hu, Schiele Francois, Meneveau Nicolas, Seronde Marie-France, Legalery Pierre, Bonneville Jean-Francois, Chocron Sidney, Bassand Jean-Pierre
Department of Cardiology, University Hospital Jean Minjoz, Besançon, France.
Int J Cardiovasc Imaging. 2006 Oct;22(5):653-6. doi: 10.1007/s10554-005-9064-5. Epub 2006 Apr 28.
A 72-year-old man was admitted to our hospital for acute back pain. Transesophageal echocardiography (TEE), computed tomography (CT) and magnetic resonance imaging (MRI) all showed the presence of intramural hematoma (IMH) located in the descending aorta, with bilateral pleural effusions. The patient was initially referred for medical therapy and 'watchful waiting'. However, he continued to have back pain, so we decided to perform invasive aortography examination and intra-aortic ultrasound (IAU) imaging. No penetrating aortic ulcer (PAU) was found on multiple angiographic views, but intra-aorta ultrasound imaging clearly showed a PAU measuring 3x1 mm(2) in connection with the intramural hematoma. Even retrospective analysis of CT images failed to reveal this PAU. Therefore, we think that IAU imaging may be a useful tool in the diagnosis of PAU.
一名72岁男性因急性背痛入住我院。经食管超声心动图（TEE）、计算机断层扫描（CT）和磁共振成像（MRI）均显示降主动脉存在壁内血肿（IMH），伴有双侧胸腔积液。该患者最初接受药物治疗并“密切观察”。然而，他持续存在背痛，因此我们决定进行有创主动脉造影检查和主动脉内超声（IAU）成像。在多个血管造影视图上未发现穿透性主动脉溃疡（PAU），但主动脉内超声成像清楚地显示了一个与壁内血肿相关的大小为3×1 mm²的PAU。即使对CT图像进行回顾性分析也未能发现这个PAU。因此，我们认为IAU成像可能是诊断PAU的一种有用工具。
