Chest CT Appearances

Intramural Hematoma CT Findings

• Crescentic hyperattenuating fluid collection
• Thickened aortic wall
• Aortic wall is smooth and does not enhance
• Focal ulceration from true lumen is common
• Sometimes easier to appreciate on non-contrast CT
• Can resolve over time in select patients

Other Information About Intramural Hematoma

Etiology:

• Chronic high blood pressure
• Marfan syndrome
• Bicuspid aortic valve

Epidemiology:

• More prevalent in men
• 7th-9th decade of life

Presentation:

• Chest, back and/or abdominal pain
• Shortness of breath
• Weakness
• Syncope
• Nausea

Prognosis:

• Over 90% survival rate