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A Case of Spontaneous Mediastinal Hematoma Diagnosed by MR Imaging Tetsuya Tanaka 1 , Kouichi Kawata 1 , Takahisa Sawada 1 , Kouki Tsuruyama 1 , Takaaki Mizutani 1 , Ken Takahashi 2 , Masao Nakagawa 3 1Division of Cardiology, Ayabe Municipal Hospital 2Department of Radiology, Kyoto Prefectural University of Medicine 3Second Department of Internal Medicine, Kyoto Prefectural University of Medicine Keyword: MRI , 特発性縦隔血腫 , spontaneous mediastinal hematoma , severe chest pain pp.515-519
Published Date 1995/5/15
DOI https://doi.org/10.11477/mf.1404901061
  • Abstract
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A 65-year-old man was admitted to our hospital with acute onset of sharp tearing chest and back pain while he was fishing. Ile had no history of hypertension or hematological disorders. On examination, his blood pressure was 110/64mmHg and his heart rate was 117/ min with atrial fibrillation rhythm on electrocardio-gram. Chest X-ray films showed normal. Chest and back pain persisted over 3 hours and then computed tomography (CT) with intravenous contrast medium was carried out. It confirmed a slightly enhanced elliptic mass surrounding the esophagus and descending aorta at the posterior mediastinum. Transesophageal ultrasound examination showed a low echoic mass between the left atrium and the descending aorta. A digital subtraction aortogram performed 12 hours after onset showed no aortic abnormality. There was no evidence of intimal flap, false lumen or penetrating spot with these examinations.

We observed this lesion by magnetic resonance imag-ging (MRI) at both the acute and chronic phases. From changing patterns of spin echo images, this lesion wasdiagnosed as mediastinal hematoma. Spontaneous mediastinal hematoma is rarely encountered without any underlying disorders.

He was treated conservatively with no complication and remained well on follow-up 1 year later.

Thus MRI was an effective method for diagnosing this lesion.


Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.

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