Penetrating Aortic Ulcer

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Penetrating atherosclerotic ulcer of the aorta is characterized by ulceration of an atheromatous plaque disrupting the internal elastic lamina with associated hematoma formation within the media of the aortic wall.

Yucel EK, Steinberg FL, Egglin TK, et al. Penetrating aortic ulcers: diagnosis with MR imaging. Radiology 1990; 177:779-81.

Kazerooni EA, Bree RL, Williams DM, et al. Penetrating atherosclerotic ulcers of the descending thoracic aorta: evaluation with CT and distinction from aortic dissection. Radiology 1992; 183:759-65.

The original radiologic description:
Stanson AW, Kazmier FJ, Hollier LH, et al. Penetrating atherosclerotic ulcers of the thoracic aorta: natural history and clinicopathologic correlations. Ann Vasc Surg 1986; 1:15-23.

It is commonly seen in elderly patients with severe atherosclerotic disease presenting with chest and/or back pain, although most are diagnosed in asymptomatic patients who undergo imaging for other reasons.

Quint LE, Williams DM, Francis IR, et al. Ulcer-like lesions of the aorta: imaging features and natural history. Radiology 2001; 218:719-23.

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by Dr Olga Shindler