Abstract
A 72-year-old man was admitted to our hospital for acute back pain. Transesophageal echocardiography (TEE), computed tomography (CT) and magnetic resonance imaging (MRI) all showed the presence of intramural hematoma (IMH) located in the descending aorta, with bilateral pleural effusions. The patient was initially referred for medical therapy and ‘watchful waiting’. However, he continued to have back pain, so we decided to perform invasive aortography examination and intra-aortic ultrasound (IAU) imaging. No penetrating aortic ulcer (PAU) was found on multiple angiographic views, but intra-aorta ultrasound imaging clearly showed a PAU measuring 3×1 mm2 in connection with the intramural hematoma. Even retrospective analysis of CT images failed to reveal this PAU. Therefore, we think that IAU imaging may be a useful tool in the diagnosis of PAU.
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References
Stanson AW, Kazmier FJ, Hollier LH, et al (1986) Penetrating atherosclerotic ulcers of the thoracic aorta: natural history and clinicopathologic correlations. Ann Vasc Surg. 1:15–23
Vilacosta I, San Roman JA, Aragoncillo P, et al (1998) Penetrating atherosclerotic aortic ulcer: documentation by transesophageal echocardiography. J Am Coll Cardiol. 32:83–89
Sueyoshi E, Matsuoka Y, Imada T, et al (2002) New development of an ulcerlike projection in aortic intramural hematoma: CT evaluation. Radiology. 224:536–541
Ganaha F, Miller DC, Sugimoto K, et al (2002) Prognosis of aortic intramural hematoma with and without penetrating atherosclerotic ulcer: a clinical and radiological analysis. Circulation. 106:342–348
Coady MA, Rizzo JA, Hammond GL, et al (1998) Penetrating ulcer of the thoracic aorta: what is it? How do we recognize it? How do we manage it?. J Vasc Surg. 27:1006–1015; discussion pp. 1015–1016
Cho KR, Stanson AW, Potter DD, et al (2004) Penetrating atherosclerotic ulcer of the descending thoracic aorta and arch. J Thorac Cardiovasc Surg. 127:1393–1399; discussion pp. 1399–1401
Hagan PG, Nienaber CA, Isselbacher EM, et al (2000) The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. Jama. 283:897–903
Hayashi H, Matsuoka Y, Sakamoto I, et al (2000) Penetrating atherosclerotic ulcer of the aorta: imaging features and disease concept. Radiographics. 20:995–1005
Yucel EK, Steinberg FL, Egglin TK, et al (1990) Penetrating aortic ulcers: diagnosis with MR imaging. Radiology. 177:779–81
Yamada E, Matsumura M, Kyo S, et al (1995) Usefulness of a prototype intravascular ultrasound imaging in evaluation of aortic dissection and comparison with angiographic study, transesophageal echocardiography, computed tomography, and magnetic resonance imaging. Am J Cardiol. 75:161–5
Alfonso F, Goicolea J, Aragoncillo P, et al (1995) Diagnosis of aortic intramural hematoma by intravascularultrasound imaging. Am J Cardiol. 76:735–738
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Wei, H., Schiele, F., Meneveau, N. et al. Potential interest of intra-aorta ultrasound imaging for the diagnosis of aortic penetrating atherosclerotic ulcer. Int J Cardiovasc Imaging 22, 653–656 (2006). https://doi.org/10.1007/s10554-005-9064-5
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DOI: https://doi.org/10.1007/s10554-005-9064-5