High-attenuation crescent sign
Updates to Article Attributes
The high attenuating crescent sign represents an acute haematoma within either the mural thrombus or the aneurysm wall, especially when detected on unenhanced CT scans. It is a specific sign of impending abdominal aortic aneurysm (AAA) rupture or so-called contained rupture.
Pathology
The hyperattenuation is caused by fresh blood that first insinuates itself into the mural thrombus and later penetrates the aortic wall. Thus, the pathophysiology is not similar to that of an intramural haematoma, in which haemorrhage occurs from within the aortic wall.
The sensitivityAs an indicator of theAAA complicated by intramural haematoma, contained or uncontained rupture; high-attenuating crescent sign as an indication of a complicated aneurysm ishas been shown 77%; specificity sensitive, 93%; specific, and has a positive predictive value of 53%1.
Treatment and prognosis
When seeing this sign in an aneurysm, especially in patients with pain, it is warranted to inform the referring physician or surgeon about the high risk for aneurysmal rupture, even if there are no primary or frank signs of leakage. This condition may require emergent surgical management and warrants close vitals monitoring.
-<p>The <strong>high attenuating crescent</strong> <strong>sign </strong>represents an acute haematoma within either the mural thrombus or the aneurysm wall, especially when detected on unenhanced CT scans. It is a specific sign of impending <a href="/articles/abdominal-aortic-aneurysm-rupture-2">abdominal aortic aneurysm (AAA) rupture</a> or so-called contained rupture.</p><h4>Pathology</h4><p>The hyperattenuation is caused by fresh blood that first insinuates itself into the mural thrombus and later penetrates the aortic wall. Thus, the pathophysiology is not similar to that of an <a href="/articles/aortic-intramural-haematomas">intramural haematoma</a>, in which haemorrhage occurs from within the aortic wall.</p><p>The sensitivity of the high-attenuating crescent sign as an indication of a complicated aneurysm is 77%; specificity, 93%; and positive predictive value of 53%.</p><h4>Treatment and prognosis</h4><p>When seeing this sign in an <a href="/articles/aneurysm">aneurysm</a>, especially in patients with pain, it is warranted to inform the referring physician or surgeon about the high risk for aneurysmal rupture, even if there are no primary or frank signs of leakage. This condition may require emergent surgical management and warrants close vitals monitoring.</p>- +<p>The <strong>high attenuating crescent</strong> <strong>sign </strong>represents an acute haematoma within either the mural thrombus or the aneurysm wall, especially when detected on unenhanced CT scans. It is a specific sign of impending <a href="/articles/abdominal-aortic-aneurysm-rupture-2">abdominal aortic aneurysm (AAA) rupture</a> or so-called contained rupture.</p><h4>Pathology</h4><p>The hyperattenuation is caused by fresh blood that first insinuates itself into the mural thrombus and later penetrates the aortic wall. Thus, the pathophysiology is not similar to that of an <a href="/articles/aortic-intramural-haematomas">intramural haematoma</a>, in which haemorrhage occurs from within the aortic wall.</p><p>As an indicator of AAA complicated by intramural haematoma, contained or uncontained rupture; high-attenuating crescent sign has been shown 77% sensitive, 93% specific, and has a positive predictive value of 53% <sup>1</sup>.</p><h4>Treatment and prognosis</h4><p>When seeing this sign in an <a href="/articles/aneurysm">aneurysm</a>, especially in patients with pain, it is warranted to inform the referring physician or surgeon about the high risk for aneurysmal rupture, even if there are no primary or frank signs of leakage. This condition may require emergent surgical management and warrants close vitals monitoring.</p>
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