This evaluation demonstrates differences in acute and chronic aortic disease using imaging in a patient with aneurysm, suggesting better management strategies.
Aortic dissection is evaluated by CT angiography (CTA). FDG can highlight the active inflammation, which can help differentiate acute from chronic wall disease. A 58-year-old man with multiple comorbidities developed acute epigastric pain and hemoptysis. He was referred for management of ~5.8 cm thoraco-abdominal aortic aneurysm (TAAA) detected on CTA. 18 F-FDG PET/CT was ordered and revealed intensely avid intramural hematoma along the wall of the proximal descending thoracic aorta, reflecting acute dissection coexisting with distal, less hypermetabolic chronic intramural hematoma.
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Tulbah et al. (2026) studied this question.
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