Sueyoshi E, Matsuoka Y, Sakamoto I, Uetani M, Hayashi K, Narimatsu M
Department of Radiology, Nagasaki University School of Medicine, Japan.
J Comput Assist Tomogr. 1997 Nov-Dec;21(6):931-8. doi: 10.1097/00004728-199711000-00016.
Our goal was to investigate the fate of intramural hematoma of the aorta.
In 32 patients with intramural hematoma of the aorta, we reviewed CT (n = 32) and MR (n = 22) findings. The diagnosis was established by CT, and regular follow-up studies were performed.
All intramural hematomas decreased in size. Ulcer-like projections (ULPs) were identified at the initial study in 6 patients and during the follow-up period in 14 patients. The ULPs progressed to saccular aneurysm in 12 patients (mean 47.0 days), while fusiform aneurysm developed in 6 patients (mean 347.7 days) without ULP. In two patients, the affected aorta progressed to overt aortic dissection.
Intramural hematoma itself usually decreases in size. However, the affected aorta can progress to aneurysm or overt aortic dissection. Development of saccular aneurysm from ULPs can be considered an early complication. In cases without ULP, fusiform aneurysm may develop as a late complication. All intramural hematomas need to be followed since it seems to be difficult to predict the exact fate of intramural hematoma from the initial imaging findings.
我们的目标是研究主动脉壁内血肿的转归。
对32例主动脉壁内血肿患者，我们回顾了CT（n = 32）和MR（n = 22）检查结果。诊断通过CT确立，并进行定期随访研究。
所有壁内血肿大小均减小。6例患者在初始检查时发现溃疡样突出（ULP），14例患者在随访期间发现。12例患者的ULP进展为囊状动脉瘤（平均47.0天），6例无ULP的患者发展为梭形动脉瘤（平均347.7天）。2例患者受累主动脉进展为典型主动脉夹层。
主动脉壁内血肿本身通常会缩小。然而，受累主动脉可进展为动脉瘤或典型主动脉夹层。ULP发展为囊状动脉瘤可视为早期并发症。在无ULP的情况下，则可能作为晚期并发症发展为梭形动脉瘤。所有壁内血肿均需随访，因为从初始影像学表现似乎难以预测壁内血肿的确切转归。
