EURORAD ESR

Case 12305

Acute ascending thoracic aortic rupture due to penetrating atherosclerotic ulcer

Author(s)
Lopes Dias J, Costa NV, Leal C, Alves P, Bilhim T

Hospital de S. José, Serviço Imagiologia; Jardim dos Jacarandás 4.28 01 C,
4º A 1990-237 Lisbon, Portugal;
Email:joaolopesdias85@gmail.com
 
Patient
female, 68 year(s)
 
 
  • Figure 1
    Frontal chest radiograph.

    Widened mediastinum and enlargement of the cardiac silhouette.

     
    Area of Interest: Emergency; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 2
    Contrast material–enhanced CT

    Hyperattenuating pericardial effusion with near 70 HU (ROI, region of interest).

     
    Area of Interest: Emergency; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 3
    Contrast material–enhanced CT

    Hyperattenuating intramural hematoma in the ascending thoracic aorta (74 HU, ROI). Pericardial hemorrhagic effusion (blue arrow) and stranding of the mediastinal fat planes (red arrow) are also seen.

     
    Area of Interest: Emergency; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 4
    Contrast material–enhanced CT

    Penetrating ulcer in the asscending thoracic aorta (blue arrow) with surrounding intramural hematoma, seen as a peripheral hyperattenuating crescent (black arrow).

     
    Area of Interest: Emergency; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 5
    Volume rendering reconstruction.

    Penetrant ulcer in the ascending thoracic aorta.

     
    Area of Interest: Emergency; Imaging Technique: CT-Angiography; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
Widened mediastinum and enlargement of the cardiac silhouette.
 
Hyperattenuating pericardial effusion with near 70 HU (ROI, region of interest).
 
Hyperattenuating intramural hematoma in the ascending thoracic aorta (74 HU, ROI). Pericardial hemorrhagic effusion (blue arrow) and stranding of the mediastinal fat planes (red arrow) are also seen.
 
Penetrating ulcer in the asscending thoracic aorta (blue arrow) with surrounding intramural hematoma, seen as a peripheral hyperattenuating crescent (black arrow).
 
Penetrant ulcer in the ascending thoracic aorta.
 
 
 
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