Intramural blood pool (aorta)
Citation, DOI, disclosures and article data
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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 CT 2. They are more common in patients whose intramural hematoma thickness exceeds 10 mm.
Intramural blood pools are located within the intramural hematoma and either do not visibly communicate with the true lumen, or do so only via 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. Bronchial arteries are less commonly implicated 2.
Treatment and prognosis
Unlike ulcer-like projections, intramural blood pools do not adversely affect prognosis, often regress spontaneously, and require no dedicated treatment 1. CTA follow-up is important. Occasionally, endovascular coil embolization is offered to patients with enlarging symptomatic intramural blood pools 2.
- 1. Ming-Ting Wu, Yen-Chi Wang, Yi-Luan Huang, Ruey-Sheng Chang, Shang-Chieh Li, Pinchen Yang, Tung-Ho Wu, Kuan-Rau Chiou, Jer-Shyung Huang, Huei-Lung Liang, Huey-Ben Pan. Intramural Blood Pools Accompanying Aortic Intramural Hematoma: CT Appearance and Natural Course. (2011) Radiology. doi:10.1148/radiol.10101270
- 2. Ko JP, Goldstein JM, Latson LA, Azour L, Gozansky EK, Moore W, Patel S, Hutchinson B. Chest CT Angiography for Acute Aortic Pathologic Conditions: Pearls and Pitfalls. (2021) Radiographics : a review publication of the Radiological Society of North America, Inc. 41 (2): 399-424. doi:10.1148/rg.2021200055 - Pubmed