孤立性肠系膜上动脉夹层动脉瘤的CT诊断价值

Evaluation of Isolated Superior Mesenteric Artery Dissection with MSCT

目的探讨多层螺旋CT(MSCT)对孤立性肠系膜上动脉夹层动脉瘤的诊断价值。方法回顾性分析6例孤立性肠系膜上动脉夹层动脉瘤的多层螺旋CT表现及临床治疗措施,并根据Sakamoto描述分型。结果多层螺旋CT轴位图像均能显示肠系膜上动脉夹层的真、假腔,并可清楚显示内膜瓣,后处理图像MPR、MIP、VR亦可清楚显示;动脉管径不同程度扩张,10～15mm,周围脂肪密度增高、间隙模糊;依据Sakamoto分型,有4例Ⅰ型,1例Ⅲ型,1例Ⅳ型;5例内科保守治疗,1例腔内支架治疗。结论多层螺旋CT有助于孤立性肠系膜上动脉夹层动脉瘤的诊断和临床治疗方法的选择,具有重要的诊断价值。

Objective To evaluate the features of isolated superior mesenteric artery dissection with MSCT. Methods The CT fea- tures and the clinical data of isolated superior mesenteric artery dissection in 6 patients were reviewed retrospectively. Sakamoto＇s classifi- cation was analyzed. Results MSCT demonstrated the true and false lumens and the intimal flap in all six patients. The images of MPR, MIP,VR also showed clearly. Other CT findings were enlarged diameter of the superior mesenteric artery （10 - 15mm） ,and increased at-tenuation of the fat around the artery. According to Sakamoto＇s classification,there were four type Ⅰ ,one type Ⅲ ,and one type Ⅳ. One pa- tient needed endovascular therapy,others were conservative treatment. Conclusion MSCT is useful for the diagnosis and the clinical ther- apy of isolated superior mesenteric artery dissection,and has important clinical diagnostic value.