Intramural aortic dissection.

We present 10 cases of intramural aortic dissection. The cases are all characterized by the presence of intramural haematoma without the presence of a patent false lumen. The radiological features and possible aetiologies are discussed. The key radiological finding is the presence of a hyperdense rim in the aortic wall on a non-contrast-enhanced computed tomography (CT) scan. In one case, a delayed diagnosis was made using magnetic resonance imaging (MRI). In a further case, the delayed development of a large aortic ulcer was demonstrated. Intramural aortic dissection has only recently been described in the radiological literature. The aetiology of this condition remains controversial. The imaging findings may be subtle and the diagnosis is still frequently being overlooked. We believe CT to be the primary diagnostic test for this condition, and its advantages over MRI and transoesophageal echocardiography (TOE) are discussed.