The following is a summary of “Clinical and imaging differences between Stanford Type B intramural hematoma-like lesions and classic aortic dissection,” published in the July 2023 issue of Cardiology by Wei et al.
Researchers performed a retrospective study to explore the differences between Intramural Hematoma (IMH) and Aortic Dissection (AD) with clinical manifestations and imaging features of patients with acute Stanford type B IMH-like lesions and acute Stanford type B AD (ATBAD).
They analyzed clinical & computed tomography angiography (CTA) imaging data of 42 patients with IMH-like lesions with ulcer-like projection (ULP) and 38 ATBAD patients and compared their clinical and imaging features.
The results showed IIMH-like lesions: fewer aortic segments involved than ATBAD (5.6 ± 2.2 vs. 7.1 ± 1.9 segments, P< 0.005). Less branch involvement compared to the ATBAD group (P< 0.001). ATBAD group has a higher incidence rate of back pain than the IMH-like lesions group (71.1% vs. 26.2%, P< 0.05). ULPs of IMH-like lesions and intimal tears of zone 4 of the descending thoracic aorta were the predominant location for the presence of ATBAD, with a slightly higher concentration in the upper quadrant outside the lumen (64.3% vs. 65.8%, P> 0.05). ULPs in IMH-like lesions had a smaller maximum diameter than intimal tears in ATBAD (7.4 ± 3.4 vs. 10.8 ± 6.8 mm, P = 0.005). The Lumen compression ratio in IMH-like lesions was smaller than in the ATBAD group (P< 0.05). IMH-like lesion patients had fewer involved aortic segments than ATBAD patients (5.6 ± 2.2 vs. 7.1 ± 1.9 segments, P< 0.005) and less branch involvement (P< 0.001).
Investigators concluded that IMH-like lesions and intimal tears are the initial factors in ATBAD, with similar ULPs and lesion involvement.