Abstract：Objective: To explore the CT examination technique and manifestations of intramural aortic hematoma(IAH) and determine the diagnostic value of 16-slice spiral CT for IAH. Materials and Methods: Twenty-two patients who suspected of aortic emergency were refered to our department. The 1.25mm slice thickness were used to reconstruct images for post-processing using 16-slice spiral CT. The multiplanar reconstruction(MPR), curved planar reconstruction(CPR), maximum intensity projection(MIP) and volume rendering(VR) were used. Results: Twenty-one of the 22 IAH were type B, which the descending aorta was involved in 5 cases, thoracic and abdominal aorta were involved in 15 cases and 2 cases located in abdominal aorta. Six cases were accompanied by penetrating atherosclerotic ulcer, 11 cases had atherosclerosis, and 5 cases had aortic aneurysms. Conclusion: For evaluating IAH with 16-slice spiral CT, plain scan and bi-phase postcontrast imaging of the entire aorta should be made. Axial image is the main source of diagnostic information. On non-contrast examination, the important signs of IAH include crescent-shaped hyperdensity or heterogeneous hyperattenuation lesions within the wall and calcified intima shift endocentrically. There is no enhancement and intimal flap after contrast medium injection. Other aortic diseases such as penetrating ulcer could be found in IAH cases. Based on the above mentioned findings, IAH could be differentiated from other acute aortic diseases.
2008, Vol. 19 
