Murray J G, Manisali M, Flamm S D, VanDyke C W, Lieber M L, Lytle B W, White R D
Department of Radiology, Cleveland Clinic Foundation, OH 44195, USA.
Radiology. 1997 Aug;204(2):349-55. doi: 10.1148/radiology.204.2.9240519.
To evaluate magnetic resonance (MR) imaging findings of intramural hematoma of the thoracic aorta and their relationship to prognosis.
MR images of 22 patients with intramural hematoma of the thoracic aorta were reviewed retrospectively. Site, thickness, degree of mural involvement, and signal intensity on spin-echo (SE) and cine gradient-echo (GRE) images of the hematoma were noted. MR findings of patients who did and those who did not develop complications were compared.
Hematoma site was the only MR finding that correlated significantly with patient outcome. Complication frequencies in four (80%) of five patients with hematoma of the ascending aorta (type A) and in two (12%) of 17 patients with hematoma of the descending aorta (type B) were significantly different (P = .009). There were moderately strong correlations between days after symptom onset and signal intensity of the hematoma on SE (r = 0.78) and GRE (r = 0.72) images. MR images of two of three patients who developed early-subacute complications showed signal intensity changes of the hematoma that were consistent with recurrent bleeding.
Patients with MR findings consistent with type A intramural hematoma of the thoracic aorta should undergo surgery. In cases of type B intramural hematoma of the thoracic aorta, MR imaging can be useful for detecting complete resolution or impending complications of the hematoma.
评估胸主动脉壁内血肿的磁共振（MR）成像表现及其与预后的关系。
回顾性分析22例胸主动脉壁内血肿患者的MR图像。记录血肿的部位、厚度、壁受累程度以及自旋回波（SE）和电影梯度回波（GRE）图像上的信号强度。比较发生并发症和未发生并发症患者的MR表现。
血肿部位是唯一与患者预后显著相关的MR表现。升主动脉血肿（A型）5例中有4例（80%）和降主动脉血肿（B型）17例中有2例（12%）的并发症发生率有显著差异（P = 0.009）。症状出现后天数与血肿在SE（r = 0.78）和GRE（r = 0.72）图像上的信号强度之间存在中等强度的相关性。发生早期亚急性并发症的3例患者中有2例的MR图像显示血肿信号强度变化与再次出血一致。
MR表现符合胸主动脉A型壁内血肿的患者应接受手术治疗。对于胸主动脉B型壁内血肿，MR成像可用于检测血肿的完全消退或即将发生的并发症。
