Journal of the Belgian Society of Radiology
Highlights
- When associated with Stanford type A AAD, PA-IMH may result from blood extravasation secondary to rupture of the posterior wall of the ascending aorta into the common aortopulmonary adventitia (View Highlight)
- studies have shown that 9–16% of patients with Stanford type A AAD present with hemorrhage extending along the pulmonary artery (View Highlight)
- Anatomically, the ascending aorta, main pulmonary artery, and pulmonary arteries (left and right) share a common adventitia (View Highlight)
- Among patients with rupture of the posterior wall of the aortic root, the extravasated blood may enter the common adventitia, easily extending in the adventitial space of the main pulmonary artery and thereafter into the adventitial space of the left and/or right pulmonary arteries, resulting in PA-IMH (View Highlight)
- The diagnosis of PA-IMH is generally established via non-contrast-enhanced CT, which typically shows hyperdense thickening of the pulmonary arterial wall (View Highlight)
- In severe cases, the vessel may continue to dissect into more peripheral pulmonary branches and extend into the alveoli, leading to alveolar hemorrhage. This CT finding has been reported to be a significant prognosticator of mortality (View Highlight)