SERIAL MRI IN THE MANAGEMENT OF INTRAMURAL HEMORRHAGE OF THE THORACICAORTA

Acute intramural haematoma of the ascending and descending aorta was d iagnosed by CT in a patient with chest pain and suspected thoracic aor tic dissection. Surgical mortality from aortic replacement in this con dition is high. Intramural haematoma has an unpredictable course but s tudies suggest that resolution of haematoma carries a favourable progn osis against further complications. Serial MR examinations over the ne xt 6 weeks demonstrated resolution of the haematoma. This information influenced the decision not to undertake surgery and the patient was c ontinued on antihypertensive medication. Serial MR examination is a sa fe and reliable method of monitoring the progress of intramural haemat oma and thus guiding difficult treatment decisions.