PMC5087263_01
(a) Sagittal CT of the abdomen and pelvis with contrast shows a 6.5 cm AAA with the 'hyperattenuating crescent sign' seen on both the anterior (white arrowheads) and posterior (black arrowheads) margin of the aorta. (b) Axial CT of the abdomen with contrast shows an AAA with a focal fissure extending into the mural thrombus (black arrowhead) and the 'hyperattenuating crescent sign' seen as a crescent-shaped area of enhancement (white arrowheads) in the lateral margin of the thrombus. The anterior margin of the psoas muscle is obscured by a blood collection (asterisk), representing a sentinel leak.
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There was a sharp, focal extension of the opacified lumen extending into the mural thrombus, and a hyperattenuating crescent in the wall of the thrombus (Fig. 1). Adjacent to the aneurysm, there was stranding of the mesenteric fat, as well as a collection of fluid obscuring the anterior margin of the psoas muscle (Fig. 1).