Intramural blood pool (aorta)
Intramural blood pools (IMBPs), also known as aortic branch artery pseudoaneurysms, are small foci of contrast enhancement within a recent aortic intramural hematoma seen on contrast-enhanced CTs 2. The IMBPs are more common in patients whose IMH thickness exceeds 10 mm.
Radiographic features
CT
IMBPs are located within the intramural hematoma and either do not visibly communicate with the true lumen, or do so via only a very small (< 2 mm) ostium 1. They are most frequently located within the descending thoracic and abdominal aorta in hematomas at least 10 mm in thickness 1. Additionally, they are often associated with an adjacent intercostal artery or lumbar artery 1. Less common aortic branches implicated include the bronchial arteries 2.
Treatment and prognosis
Unlike ulcer-like projections, intramural blood pool to not adversely affect prognosis, often spontaneously regress, and require no dedicated treatment 1. CTA follow up is important as occasionally endovascular coil embolization is offered to patients with enlarging symptomatic IMBPs 2.
Related Radiopaedia articles
Aortic pathology
- acute aortic syndrome
- aortic aneurysms
- inflammatory
- congenital
- aortic coarctation
- aortic pseudocoarctation
- cervical aortic arch
- interrupted aortic arch
- transposition of the great arteries
- variant anatomy of the aortic arch
- traumatic aortic injury
- miscellaneous
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