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Penetrating Atherosclerotic Ulcer   of the Aorta   Imaging Features and Disease Concept Present by : Ekksit Srithammasit, MD RadioGraphics 2000; 20:995–1005 Hayashi et al, Department of Radiology, Nagasaki University School of Medicine,
Introduction ,[object Object],[object Object],- F irst described by Stanson et al in  1986  -
Table of Contents ,[object Object],[object Object],[object Object],[object Object],[object Object]
Disease Course
Imaging Appearances ,[object Object],[object Object],[object Object],[object Object],[object Object]
Imaging Appearances ,[object Object],[object Object],[object Object],[object Object],[object Object]
Contrast-enhanced CT scan A 73-year-old man with terminal laryngeal cancer and sudden onset of chest pain.
[object Object],[object Object],A 73-year-old man with terminal laryngeal cancer and sudden onset of chest pain.
Photograph of the autopsy specimen A 73-year-old man with terminal laryngeal cancer and sudden onset of chest pain. Low-power photomicrograph
A 74- year-old man with sudden onset of chest pain. CECT Thoracic aortogram
A 74- year-old man with sudden onset of chest pain. ,[object Object],[object Object]
A 73-year-old man with back pain. ,[object Object],CECT 48 hours later CECT 48 hours later Oblique sagittal cine MRI 3 months later
Imaging Appearances ,[object Object],[object Object]
A 73-year-old man with back pain. ,[object Object],CECT CECT 2 weeks CECT 2 years
A 73-year-old man with back pain. ,[object Object]
A 73-year-old man with back pain. Unenhanced CT scan CECT
A 73-year-old man with back pain. Follow-up contrast-enhanced CT scan obtained 2 weeks after onset
Prognosis ,[object Object],[object Object],[object Object]
Although cases of penetrating atherosclerotic ulcer typically have many features in common  the prognosis was different from case to case .
Prognosis ,[object Object],[object Object],[object Object],[object Object]
Prognosis ,[object Object],[object Object]
An asymptomatic 65-year-old man. CT scan Shaded-surface-display image
An asymptomatic 65-year-old man.
Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Relationship between Penetrating Atherosclerotic Ulcer and Aortic Dissection
Relationship between Penetrating Atherosclerotic Ulcer and Aortic Dissection
Conclusions ,[object Object],[object Object],[object Object]
 

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