Imaging of Intramural Hematoma and Penetrating Atherosclerotic Ulcer by CT and MRI

Acute aortic Intramural hematomas (IMH) and penetrating atherosclerotic (or aortic) ulcers (PAU) are potentially life-threatening lesions that demand timely diagnosis for appropriate triage and management. Diagnosis in turn relies heavily on imaging, with computed tomography (CT) serving as the standard first-line diagnostic imaging modality and magnetic resonance imaging (MRI) and echocardiography commonly invoked for problem solving or follow-up. This chapter focuses on CT and MRI protocols, lesion characteristics, and diagnostic challenges for both IMH and PAU.