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.
Tulbah et al. (Thu,) studied this question.