Retrospective Comparative Analysis of Computed Tomography Findings of Acute and Chronic Aortic Dissections and Intramural Hematomas

Journal of Thoracic Imaging
Dexter MendozaBrent P Little

Abstract

The objective of this study was to assess the reliability of ancillary imaging findings in distinguishing acute from chronic aortic dissection (AD) and intramural hematoma (IMH) using computed tomography angiography (CTA). Two radiologists specializing in cardiothoracic and vascular imaging reviewed paired CTAs of patients with AD or IMH who underwent CTA in the acute (within 24 h of presentation) and chronic settings. The radiologists were blinded to the temporal order of the CTAs. Minimum and maximum flap thicknesses and presence or absence of pleural effusion, pericardial effusion, mediastinal hematoma or fat standing, and mediastinal lymphadenopathy were recorded. Patients included 25 male individuals and 13 female individuals with a mean age of 59 years (range: 34 to 87 y). The group included 29 AD and 9 IMH cases. The median interval between the paired CTs was 542 days (range: 100 to 2533 d). Respectively, the mean minimum flap thicknesses in the acute and chronic AD were 1.3 and 1.4 mm (P=0.3), and the mean maximum flap thicknesses were 2.7 and 2.9 mm (P=0.29). The incidences of ancillary findings in acute and chronic AD and IMH were as follows: pleural effusion (55% vs. 37%, P=0.143), pericardial effusion (8% vs. 11%, P...Continue Reading

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