PMC4861835_01
A 78-year-old woman with acute aortic syndrome presenting with intramural hematoma (IMH), or nonvisible dissection, progressing into true aortic dissection, and finally near-complete healing. Axial CT. Proximal column: descending aorta, proximal level. Distal column: descending aorta, distal level. Noncontrast CT (left) and contrast-enhanced CT angiography (right) images for each column. Day 1: Scan performed at admission showing a Stanford type B IMH extending along the descending aorta (arrows). Day 8: Progression of the IMH thickness at proximal level and evolution of the IMH into a true aortic dissection at distal level (arrows). Day 15: No change of IMH thickness at proximal level, but slight increase of false lumen size at distal level (arrows). After 6 months: Complete resolution of the IMH at proximal level, and a remarkable reduction with complete false-lumen thrombosis at distal level (arrows).
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Computed tomography (CT) showed a Stanford type B aortic IMH involving the descending aorta from the left subclavian artery to the diaphragmatic level (Figure, day 1).