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Non-contrast images show a subtle crescentic hyperdensity, suggestive of an intramural haematoma, along the wall of the ascending aorta extending to the aortic arch.
Contrast-enhanced images demonstrate an ascending aortic aneurysm (diameter 5.5 cm) with an intramural haematoma of 14 mm thickness, extending from the aortic root to the aortic arch at the origin of the right brachiocephalic trunk. Delayed post-contrast images show enhancing foci, indicative of active bleeding or intramural blood pool, within the intramural haematoma. There is no discrete intimal entry tear.
There is co-existing minimally dense, possibly hemorrhagic, pericardial fluid.