Predictive Value of Imaging Indicators for Disease Progression in Acute Stanford Type B Aortic Intramural Hematoma Without Ulcer-like Lesions
Yan Xu, Hui Xu, Nan Zhang, Yongxin Li, Erhui Zhang, Xin Zhao, Dongting Liu, Wenjing Zhao, Zehui Tang, Zhonghua Sun, Jiayi Liu, Zhaoying WenPurpose:
To investigate the clinical outcomes of acute Stanford type B intramural hematoma (TBIMH) without ulcer-like lesions following medical management and to identify predictors of disease progression.
Materials and Methods:
A retrospective analysis was performed on patients with acute TBIMH without ulcer-like lesions who received medical management. Patients were categorized into progression and nonprogression groups based on 1-year follow-up computed tomography angiography (CTA). Disease progression was defined as aortic rupture, aortic dissection, aortic enlargement (≥5 mm), or hematoma thickening (≥3 mm), while nonprogression was defined as complete/partial resolution or retention of the hematoma. A multivariate analysis identified the predictors of disease progression, and Kaplan-Meier curves were used to compare survival outcomes.
Results:
A total of 110 patients (mean age 55.9±10.5 y, 25 females) were included, with 21 patients (19.1%) showing disease progression. Multivariate analysis revealed that the maximum aortic diameter (MAD) (OR=7.6,
Conclusion:
A model based on MAD and CTmax effectively stratifies progression risk in TBIMH without ulcer-like lesions, facilitating early intervention in high-risk patients.