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MDCT in the diagnosis of penetrating atherosclerotic ulcers:
the best modality of choice

Dear readers,

One of the known abnormalities included in the “Acute Aortic Syndrome” spectrum is Penetrating Atherosclerotic Ulcer (PAU). This life-threatening condition occurs as a consequence of disruption of the aortic media layer but, differently from aortic dissection and intramural hematoma, its origin is related to specific atherosclerotic alterations in aortic segments. Nonetheless, these three different pathological entities are very difficult to discriminate. For a precise differential diagnosis, the optimal imaging modality is multidetector computed tomography (MDCT).

A comprehensive description of the characteristic features of PAUs and an accurate documentation of the advantages of MDCT for PAU evaluation and diagnosis, essential for a correct management, are provided in this month’s review from Prof. Scaglione’s medical team. The selected chapter of this month’s e-book also covers the clinical aspects of PAUs and the rigorous aortic imaging provided by the application of MDCT. Finally, we propose a clinical case illustrating the usefulness of the MDCT approach for the study of PAUs.

Suggestions for topics to be covered in future issues of this newsletter are welcome as usual. Please send your ideas to us at

From the team



Penetrating atherosclerotic ulcer of aortic arch
Analysis by G. Dell’Aversano Orabona, V. Pennacchio, A. Rengo, M. Scaglione

Penetrating atherosclerotic ulcer (PAU) is an aortic wall lesion resulting from an ulceration of an atheromatous plaque. MDCT is a valuable imaging technique able to detect PAU and to help correctly discriminate this condition among the wide spectrum of similar entities.

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Surgical Management of Aortic Pathology
Current Fundamentals for the Clinical Management of Aortic Disease

O.H. Stanger, J.R. Pepper, L.G. Svensson (Eds.) – Springer-Verlag GmbH Austria, part of Springer Nature 2019

• Front Matter
• Multidetector Computed Tomography of the Aorta