Cardiovascular Imaging

Aortic mural haematoma

collection of blood in the media of the thoracic aorta presumed to be caused by haemorrhage from the vasa vasorum. It is also called aortic dissection without intimal rupture. Mural haematoma Type A involves the ascending aorta alone or extends beyond the ascending aorta while Type B involves only the descending aorta. Clinical presentation, prognosis and method of management are the same as for the same types of classical aortic dissection.

Diagnosis can be accurately established by transoesophageal echocardiography, CT and MRI. Because an intimal flap is not present, aortography may not be diagnostic. Noncontrast enhanced CT demonstrates eccentric aortic wall thickening of high density (intramural blood). MRI shows eccentric wall thickening of high intensity on T1-weighted spin echo images and low intensity on T1- or T2-weighted images. Signal intensity is determined by the age of the intramural haematoma.

CBH