Demographics:
74 years old, Female
Indication:
Chest pain
Findings
Vascular
- Surgical changes of graft replacement of the ascending aorta with a small pseudoaneurysm arising anteriorly at the distal margin of the graft measuring 8 x 6 mm
- Extensive calcified and noncalcified plaque throughout the aortic arch and descending aorta with focal plaque ulceration in the mid descending aorta and an intramural hematoma spanning the length of the descending aorta
- The aortic arch and descending aorta each measure up to 3.7 cm in diameter
- Atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm, intramural hematoma, or dissection
Nonvascular
- Mild dependent atelectasis
- Small hiatal hernia
- Cholecystectomy changes with mild extrahepatic biliary duct dilation
- Mild splenomegaly
- Subcentimeter low density structure arising in the lower pole of the left kidney, which is too small to characterize
- Partially imaged right hip arthroplasty
- Multilevel degenerative changes of the spine with trace retrolisthesis at L1-L2 and grade 1 anterolisthesis at L4-L5
Diagnosis
Aortic intramural hematoma
Penetrating atherosclerotic ulcer
Sample Report
Intramural hematoma involving the descending thoracic aorta, likely related to a penetrating ulcer in the mid descending aorta.
Thoracic aorta measures up to 3.7 cm in diameter.
Surgical changes of graft replacement of the ascending aorta with an 8 x 6 mm pseudoaneurysm arising anteriorly along the distal aspect of the graft.
Discussion