Multidetector Computed Tomography Angiography Findings of Chronic-Contained Thoracoabdominal Aortic Aneurysm Rupture with Severe Thoracal Vertebral Body Erosion
Chronic-contained aortic aneurysm rupture with vertebral erosion is a rare entity with fatal complications. Multidetector computed tomography (CT) angiography is an important diagnostic method for the evaluation of the aortic aneurysms, their complications, and also the relationship between aneurysm and branching vessels and adjacent structures. We present the multidetector CT angiography findings of a 62-year-old patient with chronic-contained thoracoabdominal aortic aneurysm rupture causing severe vertebral body erosion. 1. Introduction Erosion of the vertebral body caused by an aortic aneurysm is a rare condition. Vertebral erosion secondary to aortic aneurysm may be due to inflammation, infection, Beh？et’s disease, and tuberculosis [1–3]. It is uncommon in primary aortic aneurysm. In the literature, there are a few case reports about chronic ruptured aortic aneurysms with vertebral body erosion [2–10]. We herein present the multidetector computed tomography (CT) angiography findings of a 62-year-old patient with thoracoabdominal aortic aneurysm causing severe vertebral body erosion. The diagnostic importance of multidetector CT angiography is emphasized in this case report because this condition, in addition to being rare, may have important complications and even can be fatal [3]. 2. Case Report A 62-year-old man was admitted to our hospital with cough and chest pain. He had a history of treated larynx carcinoma two years ago and a diagnosis of aortic aneurysm. On physical examination, an umbilical hernia, abdominal distension, and a systolic murmur at the auscultation on the abdomen were found. Blood examinations did not reveal any abnormality. Multidetector CT angiography scans were obtained in dorsal decubitus position, during maximum inspiration, by using 8-channel multidetector CT system (GE Healthcare, Milwaukee, WI, USA). Contiguous axial slices with contrast-enhanced CT scans were obtained at 2.5？mm intervals, 0.875？mm slice thickness, and 105？Kvp, 305？mA. All images were obtained at window levels appropriate for mediastinum (window width: 250–400？HU; window level: 40–50？HU). Images were reconstructed with high-resolution algorithm. Multiplanar reformatted (MPR) images were interpreted in various planes. Multidetector CT angiography revealed a thoracoabdominal aortic aneurysm. The maximum diameter of the aneurysmal sac excluding the contained rupture was about 6？cm with a mural thrombus of about 4？cm thickness at about the 12th thoracal vertebral level. There was bone lysis and destruction at the left anterolateral aspect of the 11th
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