Intramural blood pools accompanying aortic intramural hematoma: CT appearance and natural course

Ming Ting Wu, Yen Chi Wang, Yi Luan Huang, Ruey Sheng Chang, Shang Chieh Li, Pinchen Yang, Tung Ho Wu, Kuan Rau Chiou, Jer Shyung Huang, Huei Lung Liang, Huey Ben Pan

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Abstract

Purpose: To evaluate multidetector computed tomographic (CT) images to investigate the prevalence, morphology, natural course, and prognostic effect of intramural blood pools (IBPs) in patients with acute intramural hematoma (IMH). Materials and Methods: Institutional review board approval and written informed consent were obtained. Sixty-five patients (41 men; mean age, 65.9 years ± 11.3 [standard deviation]) with acute IMH undergoing three or more multidetector CT examinations during follow-up for 12 months or longer (median = 18 months), except for those undergoing surgery(n = 16), were enrolled. Associated factors of developing and resorption of IBP in IMH were analyzed by using logistic regression. Results: There were 40 IBPs in 10 patients at initial multidetector CT, and 15 new IBPs developed in 11 patients during follow-up. IBPs occurred most in the descending thoracic (55% [31 of 56]) and abdominal (41% [23 of 56]) aorta in 28% (18 of 65) of patients. During 33.8 months (range, 2.8-50 months) of follow-up in these 18 patients, 57% (32 of 56) of IBPs showed complete resorption in 15 patients, 29 % (16 of 56) of IBPs showed incomplete resorption in eight patients, and 14% (eight of 56) of IBPs had interrupted follow-up because of surgery or death in three patients. Logistic regression showed that age younger than 70 years (odds ratio [OR], 8.74; 95% confidence interval [CI]: 1.03, 76.9) and IMH wall thickness greater than 10 mm (OR, 4.93; 95% CI: 1.04, 23.0) were associated with developing IBP at initial multidetector CT, while IBP with larger transmural diameter (OR, 1.16; 95% CI: 1.02, 1.31) and multidetector CT-demonstrated connection with intercostal or lumbar artery (63% [35 of 56]) (OR, 5.44; 95% CI: 1.43, 20.9) were associated with incomplete resorption. Conclusion: IBPs are frequently observed at multidetector CT in patients with IMH. They may resolve over time or appear during follow-up. These findings are not associated with a poor prognosis, and IBPs should be distinguished from ulcerlike projections.

Original languageEnglish
Pages (from-to)705-713
Number of pages9
JournalRadiology
Volume258
Issue number3
DOIs
Publication statusPublished - Mar 1 2011
Externally publishedYes

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Hematoma
Odds Ratio
Confidence Intervals
Logistic Models
Research Ethics Committees
Informed Consent
Aorta
Thorax
Arteries

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Wu, M. T., Wang, Y. C., Huang, Y. L., Chang, R. S., Li, S. C., Yang, P., ... Pan, H. B. (2011). Intramural blood pools accompanying aortic intramural hematoma: CT appearance and natural course. Radiology, 258(3), 705-713. https://doi.org/10.1148/radiol.10101270

Intramural blood pools accompanying aortic intramural hematoma : CT appearance and natural course. / Wu, Ming Ting; Wang, Yen Chi; Huang, Yi Luan; Chang, Ruey Sheng; Li, Shang Chieh; Yang, Pinchen; Wu, Tung Ho; Chiou, Kuan Rau; Huang, Jer Shyung; Liang, Huei Lung; Pan, Huey Ben.

In: Radiology, Vol. 258, No. 3, 01.03.2011, p. 705-713.

Research output: Contribution to journalArticle

Wu, MT, Wang, YC, Huang, YL, Chang, RS, Li, SC, Yang, P, Wu, TH, Chiou, KR, Huang, JS, Liang, HL & Pan, HB 2011, 'Intramural blood pools accompanying aortic intramural hematoma: CT appearance and natural course', Radiology, vol. 258, no. 3, pp. 705-713. https://doi.org/10.1148/radiol.10101270
Wu, Ming Ting ; Wang, Yen Chi ; Huang, Yi Luan ; Chang, Ruey Sheng ; Li, Shang Chieh ; Yang, Pinchen ; Wu, Tung Ho ; Chiou, Kuan Rau ; Huang, Jer Shyung ; Liang, Huei Lung ; Pan, Huey Ben. / Intramural blood pools accompanying aortic intramural hematoma : CT appearance and natural course. In: Radiology. 2011 ; Vol. 258, No. 3. pp. 705-713.
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T1 - Intramural blood pools accompanying aortic intramural hematoma

T2 - CT appearance and natural course

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AU - Wang, Yen Chi

AU - Huang, Yi Luan

AU - Chang, Ruey Sheng

AU - Li, Shang Chieh

AU - Yang, Pinchen

AU - Wu, Tung Ho

AU - Chiou, Kuan Rau

AU - Huang, Jer Shyung

AU - Liang, Huei Lung

AU - Pan, Huey Ben

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Purpose: To evaluate multidetector computed tomographic (CT) images to investigate the prevalence, morphology, natural course, and prognostic effect of intramural blood pools (IBPs) in patients with acute intramural hematoma (IMH). Materials and Methods: Institutional review board approval and written informed consent were obtained. Sixty-five patients (41 men; mean age, 65.9 years ± 11.3 [standard deviation]) with acute IMH undergoing three or more multidetector CT examinations during follow-up for 12 months or longer (median = 18 months), except for those undergoing surgery(n = 16), were enrolled. Associated factors of developing and resorption of IBP in IMH were analyzed by using logistic regression. Results: There were 40 IBPs in 10 patients at initial multidetector CT, and 15 new IBPs developed in 11 patients during follow-up. IBPs occurred most in the descending thoracic (55% [31 of 56]) and abdominal (41% [23 of 56]) aorta in 28% (18 of 65) of patients. During 33.8 months (range, 2.8-50 months) of follow-up in these 18 patients, 57% (32 of 56) of IBPs showed complete resorption in 15 patients, 29 % (16 of 56) of IBPs showed incomplete resorption in eight patients, and 14% (eight of 56) of IBPs had interrupted follow-up because of surgery or death in three patients. Logistic regression showed that age younger than 70 years (odds ratio [OR], 8.74; 95% confidence interval [CI]: 1.03, 76.9) and IMH wall thickness greater than 10 mm (OR, 4.93; 95% CI: 1.04, 23.0) were associated with developing IBP at initial multidetector CT, while IBP with larger transmural diameter (OR, 1.16; 95% CI: 1.02, 1.31) and multidetector CT-demonstrated connection with intercostal or lumbar artery (63% [35 of 56]) (OR, 5.44; 95% CI: 1.43, 20.9) were associated with incomplete resorption. Conclusion: IBPs are frequently observed at multidetector CT in patients with IMH. They may resolve over time or appear during follow-up. These findings are not associated with a poor prognosis, and IBPs should be distinguished from ulcerlike projections.

AB - Purpose: To evaluate multidetector computed tomographic (CT) images to investigate the prevalence, morphology, natural course, and prognostic effect of intramural blood pools (IBPs) in patients with acute intramural hematoma (IMH). Materials and Methods: Institutional review board approval and written informed consent were obtained. Sixty-five patients (41 men; mean age, 65.9 years ± 11.3 [standard deviation]) with acute IMH undergoing three or more multidetector CT examinations during follow-up for 12 months or longer (median = 18 months), except for those undergoing surgery(n = 16), were enrolled. Associated factors of developing and resorption of IBP in IMH were analyzed by using logistic regression. Results: There were 40 IBPs in 10 patients at initial multidetector CT, and 15 new IBPs developed in 11 patients during follow-up. IBPs occurred most in the descending thoracic (55% [31 of 56]) and abdominal (41% [23 of 56]) aorta in 28% (18 of 65) of patients. During 33.8 months (range, 2.8-50 months) of follow-up in these 18 patients, 57% (32 of 56) of IBPs showed complete resorption in 15 patients, 29 % (16 of 56) of IBPs showed incomplete resorption in eight patients, and 14% (eight of 56) of IBPs had interrupted follow-up because of surgery or death in three patients. Logistic regression showed that age younger than 70 years (odds ratio [OR], 8.74; 95% confidence interval [CI]: 1.03, 76.9) and IMH wall thickness greater than 10 mm (OR, 4.93; 95% CI: 1.04, 23.0) were associated with developing IBP at initial multidetector CT, while IBP with larger transmural diameter (OR, 1.16; 95% CI: 1.02, 1.31) and multidetector CT-demonstrated connection with intercostal or lumbar artery (63% [35 of 56]) (OR, 5.44; 95% CI: 1.43, 20.9) were associated with incomplete resorption. Conclusion: IBPs are frequently observed at multidetector CT in patients with IMH. They may resolve over time or appear during follow-up. These findings are not associated with a poor prognosis, and IBPs should be distinguished from ulcerlike projections.

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