ref: JVS Jan 2017:
This relatively easy method of comparing the degree of enhancement of thrombus in the false lumen is easily obtainable and useful to a) understand the dynamics and b) predict outcome.
A total of 65 patients (42 men; mean age, 75 years) with type B IMH were evaluated retrospectively. On initial CT scans, attenuation of the false lumen (AFL) was determined before enhancement and in the early and delayed phases of contrast enhancement. Then enhancement of the false lumen (EFL) was calculated (AFL in the delayed image − AFL in the precontrast image). The Cox proportional hazards model was employed to estimate the risk of IMH-related events, including death or surgical repair.
Results
The mean AFL for precontrast CT, arterial phase enhanced CT, and delayed phase enhanced CT was 56.3 ± 10.5, 59.9 ± 10.8, and 63.7 ± 11.1 Hounsfield units, respectively, whereas the mean EFL was 7.4 ± 9.0 Hounsfield units. EFL was the only independent predictor of IMH-related events (n = 23; hazard ratio, 1.008; 95% confidence interval, 1.03-1.15; P = .0044) and IMH-related death/surgical repair (n = 10; hazard ratio, 1.111; 95% confidence interval, 1.017-1.213; P = .0197).
Conclusions
In patients with IMH, EFL is the most powerful predictor of IMH-related events, as well as IMH-related death or surgical repair.