Gros-Gean Jeanne, Lebecque Olivier, Nchimi Alain, Vlad Mihaela-Magdalena
Université catholique de Louvain, CHU UCL Namur, Department of Radiology, 1 Avenue Dr G Thérasse, 5530, Yvoir, BE.
Centre Hospitalier du Luxembourg, CHL Luxembourg, 4 Rue Nicolas Ernest Barblé, 1210, Luxembourg, LU.
J Belg Soc Radiol. 2021 Jun 8;105(1):34. doi: 10.5334/jbsr.2446.
Diagnosing acute ascending aortic dissection in patients with equivocal radiologic data may rely on associated findings such as pulmonary artery intramural hematoma. The immediate diagnosis of aortic dissection is paramount in its management. Its diagnosis may be challenging on computed tomography when the intimal flap, pathognomonic of dissection, is not readily visualized. Pulmonary artery intramural hematoma may arise from rupture of the posterior wall of the ascending aorta into the common aortopulmonary adventitia as a result of acute dissection. The clinical significance of pulmonary artery hematoma is unknown, but its presence may facilitate the diagnosis of acute dissection when other radiologic findings are equivocal. Herein, we present four cases of pulmonary artery intramural hematoma associated with Stanford type A acute aortic dissection, among whom patient outcomes depended mainly on the prompt treatment the dissection.
对于影像学数据不明确的患者，诊断急性升主动脉夹层可能依赖于相关表现，如肺动脉壁内血肿。主动脉夹层的及时诊断对其治疗至关重要。当内膜瓣（夹层的特征性表现）在计算机断层扫描中不易显影时，其诊断可能具有挑战性。急性夹层时，升主动脉后壁破裂进入主动脉肺共同外膜可导致肺动脉壁内血肿。肺动脉血肿的临床意义尚不清楚，但其存在可能有助于在其他影像学表现不明确时诊断急性夹层。在此，我们报告4例与A型斯坦福急性主动脉夹层相关的肺动脉壁内血肿病例，其中患者的预后主要取决于夹层的及时治疗。
